MEDICARE: GOPIKISHAN R. RANGARAJ 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	207R00000X	Internal Medicine Physician	K1633	TX
2	207RI0200X	Infectious Disease Physician	K1633	TX

General Provider Information

NPI Number	:	1194751214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GOPIKISHAN R. RANGARAJ M.D.

Provider Business Mailing Address
First Line	:	509 W TIDWELL RD STE 316
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-4355
Country	:	US
Telephone Number	:	713-742-8200
Fax Number	:	713-742-8202

Provider Business Practice Location Address
First Line	:	509 W TIDWELL RD STE 316
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-4355
Country	:	US
Telephone Number	:	713-742-8200
Fax Number	:	713-742-8202

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	07/09/2014

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