=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386185536
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASWINI RAJAN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2017
-----------------------------------------------------
Last Update Date | 05/07/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 E WHITESTONE BLVD BLDG C
-----------------------------------------------------
City | CEDAR PARK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78613-7558
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-259-3467
-----------------------------------------------------
Fax | 512-406-7303
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6210 E HWY 290 STE 240
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78723-1144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-338-3826
-----------------------------------------------------
Fax | 512-406-6216
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | S5475
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------