| Kanthi Raju, D.o., P.a. | |
|
275 W Campbell Rd Suite 430 Richardson TX 75080-3601 | |
| (972) 918-0170 | |
| Not Available |
| Full Name | Kanthi Raju, D.o., P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 275 W Campbell Rd, Richardson, Texas |
| Authorized Official Name and Position | Kanthi P. Raju (D.O.) |
| Authorized Official Contact | 9729180170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kanthi Raju, D.o., P.a. Po Box 1171 Addison TX 75001-1171 Ph: (972) 991-9950 | Kanthi Raju, D.o., P.a. 275 W Campbell Rd Suite 430 Richardson TX 75080-3601 Ph: (972) 918-0170 |
| NPI Number | 1114186947 |
|---|---|
| Provider Enumeration Date | 06/06/2008 |
| Last Update Date | 07/28/2008 |
| Medicare PECOS PAC ID | 0547332017 |
|---|---|
| Medicare Enrollment ID | O20080630000104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114186947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | K1905 (Texas) | Primary |
| Provider Name | Kanthi P Raju |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124039144 PECOS PAC ID: 2668384876 Enrollment ID: I20031105000103 |
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