MEDICARE: RAJEEV SAREEN, MD

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	J1382	TX

General Provider Information

NPI Number	:	1205026416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAJEEV SAREEN, MD

Provider Business Mailing Address
First Line	:	PO BOX 2300
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78298-2300
Country	:	US
Telephone Number	:	210-614-0180
Fax Number	:	210-614-1722

Provider Business Practice Location Address
First Line	:	1905 HIGHWAY 97 E
Second Line	:	EMERGENCY ROOM
City	:	JOURDANTON
State	:	TX
Zip	:	78026-1504
Country	:	US
Telephone Number	:	830-769-4301
Fax Number	:	830-281-8521

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT
Name	:	MS. DEBORAH KIGER
Credential	:
Telephone Number	:	210-614-0181

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	11/16/2007

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