Provider Demographics
NPI:1992288997
Name:RAJAN S KOHLI MD PA
Entity type:Organization
Organization Name:RAJAN S KOHLI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KOHLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-810-4331
Mailing Address - Street 1:5606 WINTON ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5354
Mailing Address - Country:US
Mailing Address - Phone:903-806-5892
Mailing Address - Fax:469-248-0653
Practice Address - Street 1:9330 POPPY DR STE 503
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-4696
Practice Address - Country:US
Practice Address - Phone:214-810-4331
Practice Address - Fax:214-321-3469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty