# KANDASWAMY JAYARAJ MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043218514
- **Authorized official:** MR. KANDASWAMY JAYARAJ MD (OWNER)
- **Authorized official phone:** (409) 892-2111

## Contact information

- **Practice address:** 3030 NORTH ST, \#310, BEAUMONT, TX 77702-1433
- **Practice address phone:** (409) 892-2111
- **Practice address fax:** (409) 892-2173
- **Mailing address:** PO BOX 12499, 3030 N ST \#310, BEAUMONT, TX 77726-2499
- **Mailing address phone:** (409) 892-2111
- **Mailing address fax:** (409) 892-2173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | L6963 | TX | Yes |

## Other

- **Enumeration date:** 07/08/2005
- **Last updated:** 11/05/2007