Active NPI
Raja Mohan, M.D.
- Plastic Surgery Physician
- Dallas, TX
National Provider Identifier
1043534589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- Q8960
- Practice address
- 7777 Forest LN Ste C820
Dallas, TX 75230-2552 - Phone
- (469) 301-1725
- Fax
- (469) 301-1769
- NPI assigned
- Mar 25, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | UNLICENSED | MD | |
| Plastic Surgery Physician | 208200000X | Q8960 | TX | Primary |
Addresses
Primary practice location
7777 Forest LN Ste C820
Dallas, TX 75230-2552
Mailing address
7777 Forest LN Ste C820
Dallas, TX 75230-2552
Phone (469) 301-1725
Other practice location 1
909 Ese 323 Loop Ste 777
Tyler, TX 75701
Phone (903) 606-8888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q8960 | Other | TX | TMB FULL MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UNLICENSED | MD | MD | Hematology & Oncology Physician |
| Q8960 | TX | MD | Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Halani Plastic Surgery, PA | Plastic Surgery | Past | Accepting new patients |
Locations
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
909 Ese 323 Loop
Ste 777
Tyler, TX 75701
Phone (903) 606-8888
Interoperability endpoints
- rmohan617202@christushealth.direct-ci.net
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Christus Trinity Clinic
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
-
dba Christus Trinity Clinic
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
- Plastic Surgery Physician
- Arlington, TX
- NPI 1245033034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753228800000",
"number": "1043534589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7777 FOREST LN STE C820",
"city": "DALLAS",
"state": "TX",
"postal_code": "752302552",
"telephone_number": "469-301-1725",
"fax_number": "469-301-1769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7777 FOREST LN STE C820",
"city": "DALLAS",
"state": "TX",
"postal_code": "752302552",
"telephone_number": "469-301-1725",
"fax_number": "469-301-1769"
}
],
"practiceLocations": [
{
"address_1": "909 ESE 323 LOOP STE 777",
"address_purpose": "LOCATION",
"city": "TYLER",
"state": "TX",
"postal_code": "75701",
"country_code": "US",
"telephone_number": "903-606-8888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOHAN",
"first_name": "RAJA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-25",
"last_updated": "2025-07-23",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MD",
"license": "UNLICENSED",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "TX",
"license": "Q8960",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TMB FULL MEDICAL LICENSE",
"identifier": "Q8960",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.