MEDICARE: GEETHA RAO 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	208M00000X	Hospitalist Physician	R6464	TX
2	208000000X	Pediatrics Physician	33005	AZ
3	208000000X	Pediatrics Physician	R6464	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316925290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEETHA RAO MD

Provider Business Mailing Address
First Line	:	7400 FANNIN ST STE 810
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1935
Country	:	US
Telephone Number	:	713-512-8500
Fax Number	:	713-796-2121

Provider Business Practice Location Address
First Line	:	2510 W DUNLAP AVE
Second Line	:	SUITE 290
City	:	PHOENIX
State	:	AZ
Zip	:	85021-2737
Country	:	US
Telephone Number	:	602-789-0344
Fax Number	:	602-789-8279

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

Provider Enumeration Date	:	01/02/2006
Last Update Date	:	11/14/2018

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Directions to “ GEETHA RAO MD” Practice Location

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