Active NPI
Raju Rajendran, P.T
- Physical Therapist
- Beaumont, TX
National Provider Identifier
1679962757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1101087
- Practice address
- 1020.South 23Rd Street
Beaumont, TX 77707 - Phone
- (409) 840-6169
- NPI assigned
- Jan 13, 2015
- Last updated
- Jan 13, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1101087 | TX | Primary |
Addresses
Primary practice location
1020.South 23Rd Street
Beaumont, TX 77707
Mailing address
225/64.New Karkana 6TH Cross
Thiruvannamalai, TAMIL NADU 606601
IN
Phone 914175229185
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1101087 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1679962757",
"addresses": [
{
"country_code": "IN",
"country_name": "India",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "225/64.NEW KARKANA 6TH CROSS",
"city": "THIRUVANNAMALAI",
"state": "TAMIL NADU",
"postal_code": "606601",
"telephone_number": "914175229185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020.SOUTH 23RD STREET",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "77707",
"telephone_number": "409-840-6169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJENDRAN",
"first_name": "RAJU",
"credential": "P.T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-13",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1101087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.