Basic Information
| Provider Information | |||||||||
| NPI: | 1114057544 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAO | ||||||||
| FirstName: | BHASKAR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4849 N. MESA | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9153516000 | ||||||||
| FaxNumber: | 9153516601 | ||||||||
| Practice Location | |||||||||
| Address1: | 10301 GATEWAY BLVD W | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799257701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155818814 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 10/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QH0002X | P4501 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | 207R00000X | 24241 | NE | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | P4501 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.