NPIMap

Organization Active NPI

Bharath G Raj

Doing business as Holistic Psychiatry

  • Geriatric Psychiatry Physician
  • Kingwood, TX
National Provider Identifier
1386098283
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
Legal business name
BHARATH G RAJ
Doing business as
Holistic Psychiatry
Practice address
3411 Cedar Knolls Dr Ste B
Kingwood, TX 77339-2474
Phone
(281) 532-5462
Fax
(877) 796-5317
NPI assigned
Apr 17, 2016
Last updated
Nov 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bharath Gururaj Raj, MDNPI 1780840587
Title
Managing Member
Phone
(832) 410-4602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0805X Primary

Addresses

Primary practice location

3411 Cedar Knolls Dr Ste B
Kingwood, TX 77339-2474

Mailing address

3411 Cedar Knolls Dr Ste B
Kingwood, TX 77339-2474
Phone (281) 532-5462

Other practice location 1

5751 Blythewood St # 800
Houston, TX 77021-5402
Phone (832) 410-4602

Other names 1

  • Holistic Psychiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160818000959 TX Part B Supplier - Clinic/Group Practice 6002101839 Receives reassigned benefits from 14 practitioners
Practice locations: Kingwood, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2194596Bharath G Raj5751 Blythewood St, Houston, TX 77021Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory

Locations

5751 Blythewood St
Ste 700B
Houston, TX 77021
Phone (281) 532-5462

5751 Blythewood St
Ste 800
Houston, TX 77021
Phone (281) 532-5462

1849 Kingwood Dr
Ste 105
Kingwood, TX 77339
Phone (281) 532-5462

3411 Cedar Knolls Dr
Ste B
Kingwood, TX 77339
Phone (281) 532-5462

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1386098283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 CEDAR KNOLLS DR STE B",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392474",
            "telephone_number": "281-532-5462",
            "fax_number": "877-796-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 CEDAR KNOLLS DR STE B",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392474",
            "telephone_number": "281-532-5462",
            "fax_number": "877-796-5317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5751 Blythewood St # 800",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770215402",
            "country_code": "US",
            "telephone_number": "832-410-4602",
            "fax_number": "281-653-7874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BHARATH G RAJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-17",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "RAJ",
        "authorized_official_first_name": "BHARATH",
        "authorized_official_middle_name": "GURURAJ",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "832-410-4602",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holistic Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.