MEDICARE: RAJESH S PADMANABHAN MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1083895981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAJESH S PADMANABHAN MD PA

Provider Business Mailing Address
First Line	:	515 W MAYFIELD RD STE 205
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2084
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 W MAYFIELD RD STE 205
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2084
Country	:	US
Telephone Number	:	817-466-7400
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ROSARY MARLEY
Credential	:
Telephone Number	:	817-466-7400

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	11/19/2007

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