Basic Information
| Provider Information | |||||||||
| NPI: | 1225444839 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAHAJAN | ||||||||
| FirstName: | KAPIL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11665 FUQUA ST STE C301 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770344632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139479509 | ||||||||
| FaxNumber: | 7139470609 | ||||||||
| Practice Location | |||||||||
| Address1: | 2215 ROLLINGBROOK DR STE 140 | ||||||||
| Address2: | |||||||||
| City: | BAYTOWN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775213693 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142824872 | ||||||||
| FaxNumber: | 2814282784 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2014 | ||||||||
| LastUpdateDate: | 08/06/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | R5592 | TX | Y | Other Service Providers | Specialist |
No ID Information.