Healthcare Provider Details

I. General information

NPI: 1275634289
Provider Name (Legal Business Name): RAJESH RETHNAM MD., FCCP.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 12/16/2023
Certification Date: 12/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W 26TH ST STE 200
HOUSTON TX
77008-1452
US

IV. Provider business mailing address

1800 W 26TH ST STE 200
HOUSTON TX
77008-1452
US

V. Phone/Fax

Practice location:
  • Phone: 888-958-6463
  • Fax: 832-529-6463
Mailing address:
  • Phone: 888-958-6463
  • Fax: 832-529-6463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License NumberN4033
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN 4033
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberN 4033
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberN 4033
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberN4033
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: