Individual
JALAJA RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12201 RENFERT WAY, SUITE 315, AUSTIN, TX 78758-5354
(512) 837-6000
(512) 837-6001
Mailing address
12201 RENFERT WAY, SUITE 315, AUSTIN, TX 78758-5354
(512) 837-6000
(512) 837-6001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M2766
TX
207R00000X
Internal Medicine Physician
Primary
M2766
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679627467
MEDICARE GROUP # 0A5015
TX
Enumeration date
01/22/2007
Last updated
10/03/2013
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