Provider Demographics
NPI:1932239613
Name:RAJIV JOSEPH, MD, PA
Entity type:Organization
Organization Name:RAJIV JOSEPH, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-495-4411
Mailing Address - Street 1:7920 PRESTON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2343
Mailing Address - Country:US
Mailing Address - Phone:972-495-4411
Mailing Address - Fax:972-495-0624
Practice Address - Street 1:7920 PRESTON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2343
Practice Address - Country:US
Practice Address - Phone:972-495-4411
Practice Address - Fax:972-495-0624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0073CBOtherBCBS
TX0073CBMedicare PIN