MEDICARE: NITIN MAHAJAN 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	207RC0000X	Cardiovascular Disease Physician	Q0122	TX
2	207RI0011X	Interventional Cardiology Physician	Q0112	TX

General Provider Information

NPI Number	:	1467561902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NITIN MAHAJAN M.D.

Provider Business Mailing Address
First Line	:	6700 WOODLANDS PKWY
Second Line	:	STE 230 BOX 465
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382
Country	:	US
Telephone Number	:	832-296-4203
Fax Number	:	832-823-0817

Provider Business Practice Location Address
First Line	:	17070 RED OAK DR STE 305
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2616
Country	:	US
Telephone Number	:	832-296-4203
Fax Number	:	832-823-0817

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	02/13/2024

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