MEDICARE: TEJAS RAGUTHU

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	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1275371999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEJAS RAGUTHU

Provider Business Mailing Address
First Line	:	5306 PINE CLIFF DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-3140
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5306 PINE CLIFF DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-3140
Country	:	US
Telephone Number	:	929-344-8529
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2024
Last Update Date	:	02/04/2026

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Directions to “ TEJAS RAGUTHU ” Practice Location

Language	Start Address	Practice Location

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