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Individual

DR. RAJANARENDER REDDY CHOLLETI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., F.A.C.C.

Contact information

Practice address
121 NW ELLISON ST STE 105, BURLESON, TX 76028-4739
(817) 426-4700
(817) 426-4737
Mailing address
121 NW ELLISON ST STE 105, BURLESON, TX 76028-4739
(817) 426-4700
(817) 426-4737

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
209133
NY
207RC0000X
Cardiovascular Disease Physician
Primary
L0089
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0086GP
BCBS
TX
05
040329702
TX
01
10030775
AMERIGROUP
TX
01
110224533
RAILROAD MEDICARE
TX
01
7827163
AETNA
TX
01
90116910
PACIFICARE
TX
Enumeration date
04/13/2006
Last updated
01/25/2022
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