=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316947468
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAJEEV SAREEN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2005
-----------------------------------------------------
Last Update Date | 02/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1215 E COURT ST
-----------------------------------------------------
City | SEGUIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-379-2411
-----------------------------------------------------
Fax | 830-379-2558
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1215 E COURT ST
-----------------------------------------------------
City | SEGUIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78155-5129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-379-2411
-----------------------------------------------------
Fax | 830-379-2558
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 036069160
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207PE0004X
-----------------------------------------------------
Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
-----------------------------------------------------
License Number | J1382
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 036069160
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------