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General NPI Number Information
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NPI Number | 1205146511
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Entity Type | Organization
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Legal Business Name | RAJEN DESAI MD PA
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 3560 DELAWARE STE 905
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City | BEAUMONT
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State | TX
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Zip | 77706
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Country | US
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Telephone | 409-833-9662
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Fax | 409-839-8864
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Provider Business Mailing Address
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Address Line | 3560 DELAWARE STE 905
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City | BEAUMONT
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State | TX
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Zip | 77706
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Country | US
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Telephone | 409-833-9662
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Fax | 409-839-8864
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | RAJEN B DESAI
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Credential | MD PA
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Telephone | 409-833-9662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | J-1649
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License Number State | TX
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