Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | BP10039249 | TX |
NPI | 1235483652 |
---|---|
Provider Name | Rajashekhar Harish Bangalore |
First Address | Houston, TX 77030 |
Second Address | Houston, TX 77030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2012 |
Last Update Date | 07/11/2012 |