Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | S7762 | TX |
N | 2081S0010X | Sports Medicine | S7762 | TX |
N | 213ES0000X | Sports Medicine | S7762 | TX |
NPI | 1275799769 |
---|---|
Provider Name | Dr. Aditya Raghunandan |
First Address | San Antonio, TX 78240-1598 |
Second Address | San Antonio, TX 78240-1598 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 31/08/2020 |