MEDICARE: DR. BABAK REJAIE 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	2085B0100X	Body Imaging Physician	036111642	IL

General Provider Information

NPI Number	:	1275574220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BABAK REJAIE MD

Provider Business Mailing Address
First Line	:	668 BUNKER HILL RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-5119
Country	:	US
Telephone Number	:	713-416-2421
Fax Number	:	281-616-6454

Provider Business Practice Location Address
First Line	:	668 BUNKER HILL RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-5119
Country	:	US
Telephone Number	:	713-416-2421
Fax Number	:	281-616-6454

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	02/10/2011

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