Basic Information
| Provider Information | |||||||||
| NPI: | 1093322075 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARA-RAGHU, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5119 LOCUST ST | ||||||||
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| City: | BELLAIRE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774013320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5023877297 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2302 FANNIN ST STE 410 | ||||||||
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| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770029135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8325381024 | ||||||||
| FaxNumber: | 8325381023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2020 | ||||||||
| LastUpdateDate: | 09/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | PARAMESWARAN | ||||||||
| AuthorizedOfficialFirstName: | ANGELO | ||||||||
| AuthorizedOfficialMiddleName: | DUSHI | ||||||||
| AuthorizedOfficialTitleorPosition: | CO-OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5023877297 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No ID Information.