Physician Compare National (NPI:1184854721)

HEALTHCARE PROVIDER: SUBRAMANYA VARA PRASAD GAJARAJU VENKATA M.D

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1184854721
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5799059176
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170923000415
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GAJARAJU VENKATA
	Individual professional last name
Provider First Name	SUBRAMANYA
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	INTERVENTIONAL CARDIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CARDIAC ELECTROPHYSIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIAC ELECTROPHYSIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1557260064
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	158
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	505 S JOHN REDDITT DR
	Group Practice or individual's line 1 address
City	LUFKIN
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	759043120
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9366348826
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450484
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WOODLAND HEIGHTS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450211
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHI ST LUKES HEALTH MEMORIAL LUFKIN
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450508
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M