MEDICARE: RAHUL K NATH 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	208200000X	Plastic Surgery Physician	K4969	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0062LE	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1255418836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAHUL K NATH MD PA

Provider Business Mailing Address
First Line	:	PO BOX 270750
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77277-0750
Country	:	US
Telephone Number	:	713-592-9900
Fax Number	:	713-592-9921

Provider Business Practice Location Address
First Line	:	6400 FANNIN STREET STE 2290
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030
Country	:	US
Telephone Number	:	713-592-9900
Fax Number	:	713-592-9921

Authorized Official
Title or Position	:	PROVIDER
Name	:	MR. RAHUL KUMAR NATH
Credential	:	M.D.
Telephone Number	:	713-592-9900

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	01/22/2019

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Directions to “RAHUL K NATH MD PA ” Practice Location

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