Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 34566 | TX |
Y | 1223G0001X | General Practice | 34566 | TX |
Y | 213EG0000X | General Practice | 34566 | TX |
NPI | 1164904140 |
---|---|
Provider Name | Dr. Zeeshan Jamil Raja |
First Address | Sugar Land, TX 77478-4177 |
Second Address | Rosharon, TX 77583-3261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2018 |
Last Update Date | 29/06/2021 |