Individual
DR. VIVEK RAIZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3345 PLAZA 10 DR, SUITE B, BEAUMONT, TX 77707-2554
(409) 833-0444
(409) 833-9039
Mailing address
3345 PLAZA 10 DR, SUITE B, BEAUMONT, TX 77707-2553
(409) 833-0444
(409) 833-9039
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
062705100105
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176915001
—
TX
Enumeration date
08/02/2005
Last updated
12/15/2009
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