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General NPI Number Information
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NPI Number | 1386814226
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Entity Type | Individual
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Provider Name | RAJIV SHAMSHER BAHADUR VIJ M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2008
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 103 W LOOP 281 STE 474
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City | LONGVIEW
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State | TX
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Zip | 75605-4603
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Country | US
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Telephone | 903-781-0455
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Fax | 817-541-7468
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Provider Business Mailing Address
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Address Line | 103 W LOOP 281 STE 474
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City | LONGVIEW
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State | TX
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Zip | 75605-4603
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Country | US
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Telephone | 903-781-0455
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Fax | 817-541-7468
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 308639
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | N6087
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License Number State | TX
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