Basic Information
| Provider Information | |||||||||
| NPI: | 1861786576 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAGARAJ | ||||||||
| FirstName: | ARUN | ||||||||
| MiddleName: | KRISHNA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6301 GASTON AVE STE 100W | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752146273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2148273610 | ||||||||
| FaxNumber: | 2148214017 | ||||||||
| Practice Location | |||||||||
| Address1: | 6301 GASTON AVE STE 100W | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2148273610 | ||||||||
| FaxNumber: | 2148214017 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2011 | ||||||||
| LastUpdateDate: | 11/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 35126162 | OH | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | 48242 | KY | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | R6055 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.