Active NPI
Rajaram Bala, MD
- Plastic and Reconstructive Surgery Physician
- San Antonio, TX
National Provider Identifier
1457459919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- E4968
- Practice address
- 343 W Houston Street
Suite 1002
San Antonio, TX 78205-2268 - Phone
- (210) 225-3006
- Fax
- (210) 271-7755
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | E4968 | TX | Primary |
Addresses
Primary practice location
343 W Houston Street
Suite 1002
San Antonio, TX 78205-2268
Mailing address
343 W Houston St
Suite 1002
San Antonio, TX 78205-2268
Phone (210) 225-3006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | TX |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E4968 | TX | MD | Plastic and Reconstructive Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275868800000",
"number": "1457459919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "343 W HOUSTON ST",
"address_2": "SUITE 1002",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782052268",
"telephone_number": "210-225-3006",
"fax_number": "210-271-7755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "343 W HOUSTON STREET",
"address_2": "SUITE 1002",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782052268",
"telephone_number": "210-225-3006",
"fax_number": "210-271-7755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALA",
"first_name": "RAJARAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2010-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "TX",
"license": "E4968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.