Individual
RAJA MEHANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6410 FANNIN ST, SUITE 1014, HOUSTON, TX 77030-3000
(832) 325-7080
(713) 512-2239
Mailing address
6410 FANNIN ST, SUITE 1014, HOUSTON, TX 77030-3000
(832) 325-7080
(713) 512-2239
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
P7953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
315286YKY3
MEDICARE
—
05
—
326051501
—
TX
01
—
326051502
CSHCN
—
01
—
8DY143
BCBS
—
01
—
P01428484
RR MEDICARE
—
Enumeration date
01/08/2009
Last updated
08/02/2016
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