MEDICARE: RAJ SHIWACH, MD, PA

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	261QM0850X	Adult Mental Health Clinic/Center	K2288	TX
2	2084P0800X	Psychiatry Physician	K2288	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	:	1750589016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAJ SHIWACH, MD, PA

Provider Business Mailing Address
First Line	:	941 YORK DR
Second Line	:	SUITE 200
City	:	DESOTO
State	:	TX
Zip	:	75115-2066
Country	:	US
Telephone Number	:	214-884-5601
Fax Number	:	214-452-3060

Provider Business Practice Location Address
First Line	:	941 YORK DR
Second Line	:	SUITE 200
City	:	DESOTO
State	:	TX
Zip	:	75115-2066
Country	:	US
Telephone Number	:	214-884-5601
Fax Number	:	214-452-3060

Authorized Official
Title or Position	:	ACCOUNTANT
Name	:	SHERRI SMITH
Credential	:
Telephone Number	:	469-964-6827

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	03/03/2026

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