Provider Demographics
NPI:1912968629
Name:NAGARAJ, NAMITHA (MD)
Entity type:Individual
Prefix:
First Name:NAMITHA
Middle Name:
Last Name:NAGARAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5305 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2204
Mailing Address - Country:US
Mailing Address - Phone:956-213-8218
Mailing Address - Fax:956-213-8219
Practice Address - Street 1:5305 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2204
Practice Address - Country:US
Practice Address - Phone:956-213-8218
Practice Address - Fax:956-213-8219
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8853207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167808803Medicaid
TX167808806Medicaid
TX167808803Medicaid
TX8C6509Medicare PIN