Healthcare Provider Details
I. General information
NPI: 1093322075
Provider Name (Legal Business Name): PARA-RAGHU, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/24/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2302 FANNIN ST STE 410
HOUSTON TX
77002-9135
US
IV. Provider business mailing address
5119 LOCUST ST
BELLAIRE TX
77401-3320
US
V. Phone/Fax
- Phone: 832-538-1024
- Fax: 832-538-1023
- Phone: 502-387-7297
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XX0005X |
| Taxonomy | Sports Medicine (Orthopaedic Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANGELO
DUSHI
PARAMESWARAN
Title or Position: CO-OWNER
Credential: MD
Phone: 502-387-7297