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Individual
DR. RAJIV DATTATREYA
Active
Individual
DR. RAJIV DATTATREYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L0117
TX
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
L0117
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0375503 04
—
TX
05
—
037550303
—
TX
01
—
8 M2063
BC/BS
—
01
—
8J7489
MEDICARE NUMBER
TX
01
—
8L10293
MEDICARE PTAN
TX
Enumeration date
07/10/2006
Last updated
12/13/2021
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