Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | L8069 | TX |
N | 207RH0002X | Hospice and Palliative Medicine | L8069 | TX |
Y | 207RP1001X | Pulmonary Disease | L8069 | TX |
N | 207RS0012X | Sleep Medicine | L8069 | TX |
NPI | 1285647727 |
---|---|
Provider Name | Dr. Rajesh Insham Harrykissoon |
First Address | Dallas, TX 75284-4658 |
Second Address | College Station, TX 77845-6440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 10/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I02756 | (02) | TX |