MEDICARE: DR. SRIDHAR NATARAJAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZF0201X	Forensic Pathology Physician	J5422	TX
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	J5422	TX

General Provider Information

NPI Number	:	1104151208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SRIDHAR NATARAJAN M.D.

Provider Business Mailing Address
First Line	:	4434 S LOOP 289
Second Line	:	SRIDHAR NATARAJAN CHIEF MEDICAL EXAMINER
City	:	LUBBOCK
State	:	TX
Zip	:	79414-5005
Country	:	US
Telephone Number	:	806-687-9434
Fax Number	:	806-687-9438

Provider Business Practice Location Address
First Line	:	4434 S LOOP 289
Second Line	:	SRIDHAR NATARAJAN CHIEF MEDICAL EXAMINER
City	:	LUBBOCK
State	:	TX
Zip	:	79414-5005
Country	:	US
Telephone Number	:	806-687-9434
Fax Number	:	806-687-9438

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2009
Last Update Date	:	10/07/2009

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