MEDICARE: DR. KIRAN F RAJNEESH M.B.B.S., M.S.

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	2084N0400X	Neurology Physician	35126217	OH
2	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	35126217	OH
3	2084N0400X	Neurology Physician	T9589	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	:	1881919090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRAN F RAJNEESH M.B.B.S., M.S.

Provider Business Mailing Address
First Line	:	560 BLOSSOM ST STE D
Second Line	:
City	:	WEBSTER
State	:	TX
Zip	:	77598-4237
Country	:	US
Telephone Number	:	949-872-8829
Fax Number	:

Provider Business Practice Location Address
First Line	:	560 BLOSSOM ST STE D
Second Line	:
City	:	WEBSTER
State	:	TX
Zip	:	77598-4237
Country	:	US
Telephone Number	:	949-872-8829
Fax Number	:

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

Provider Enumeration Date	:	03/30/2010
Last Update Date	:	02/19/2025

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