Individual provider Active NPI

Raja Mutyala

  • Clinical Medical Laboratory
  • Houston, TX
National Provider Identifier
1538615489
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
2000 Crawford Street
Suite 1125
Houston, TX 77002
Phone
(281) 888-5564
NPI assigned
Aug 31, 2016
Last updated
Aug 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

2000 Crawford Street
Suite 1125
Houston, TX 77002

Mailing address

2000 Crawford St
Suite 1125
Houston, TX 77002-9000
Phone (281) 888-5564

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

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1538615489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 CRAWFORD ST",
            "address_2": "SUITE 1125",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770029000",
            "telephone_number": "281-888-5564",
            "fax_number": "281-888-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CRAWFORD STREET",
            "address_2": "SUITE 1125",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77002",
            "telephone_number": "281-888-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTYALA",
        "first_name": "RAJA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.