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General NPI Number Information
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NPI Number | 1700886850
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Entity Type | Individual
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Provider Name | VEENA RAJARAM MD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 5323 HARRY HINES BLVD PATHOLOGY LAB
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City | DALLAS
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State | TX
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Zip | 75390-7201
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Country | US
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Telephone | 214-648-4125
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Fax | 214-648-4070
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Provider Business Mailing Address
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Address Line | PO BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-5347
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Country | US
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Telephone | 214-456-2993
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Fax | 214-456-0779
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | P4101
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ZP0213X
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Taxonomy Name | Pediatric Pathology Physician
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License Number | P4101
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207ZN0500X
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Taxonomy Name | Neuropathology Physician
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License Number | P4101
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License Number State | TX
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