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NPI Code Detail

MEDICARE: PRASHANT GAJWANI MD

MEDICARE: PRASHANT GAJWANI MD
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
12084P0800XPsychiatry PhysicianP0585TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28CF756OTHERTXBCBSTX

General Provider Information

NPI Number : 1770509283
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRASHANT GAJWANI MD
Provider Business Mailing Address
First Line : PO BOX 20188
Second Line :
City : HOUSTON
State : TX
Zip : 77225-0188
Country : US
Telephone Number : 713-500-3500
Fax Number : 713-486-2721
Provider Business Practice Location Address
First Line : 1941 EAST RD
Second Line :
City : HOUSTON
State : TX
Zip : 77054-6010
Country : US
Telephone Number : 713-486-2500
Fax Number : 713-486-2721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 02/22/2012

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