Active NPI
Raidah Saleem Al-Baradie Sr., MD
- Child & Adolescent Psychiatry Physician
- College Station, TX
National Provider Identifier
1306084140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 219977
- Practice address
- 1800 Holleman Drive
College Station, TX 77840 - Phone
- (979) 422-3445
- NPI assigned
- Feb 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 219977 | MA | Primary |
Addresses
Primary practice location
1800 Holleman Drive
College Station, TX 77840
Mailing address
1800 Holleman Drive
College Station, TX 77840
Phone (979) 422-3445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 219977 | MA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233532800000",
"number": "1306084140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 HOLLEMAN DRIVE",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "77840",
"telephone_number": "979-422-3445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 HOLLEMAN DRIVE",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "77840",
"telephone_number": "979-422-3445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AL-BARADIE",
"first_name": "RAIDAH",
"middle_name": "SALEEM",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-02",
"last_updated": "2009-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "219977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.