Healthcare Provider Details

I. General information

NPI: 1598407017
Provider Name (Legal Business Name): RAJIV AGARWAL MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18648 MCKAY DR STE 110
HUMBLE TX
77338-5724
US

IV. Provider business mailing address

18980 W MEMORIAL DR STE 100
HUMBLE TX
77338
US

V. Phone/Fax

Practice location:
  • Phone: 831-644-8930
  • Fax: 855-227-3506
Mailing address:
  • Phone: 832-644-8930
  • Fax: 855-227-3506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RAJIV AGARWAL
Title or Position: OWNER
Credential: MD
Phone: 832-644-8930