Active NPI
Palivela P Raju, MD
- Otolaryngology Physician
- Bay City, TX
National Provider Identifier
1699758664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- G1166
- Practice address
- 600 Hospital Cir
Suite 201
Bay City, TX 77414-4771 - Phone
- (979) 241-6100
- Fax
- (979) 241-6105
- NPI assigned
- Nov 23, 2005
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | G1166 | TX | Primary |
Addresses
Primary practice location
600 Hospital Cir
Suite 201
Bay City, TX 77414-4771
Mailing address
600 Hospital Cir
Suite 201
Bay City, TX 77414-4771
Phone (979) 241-6100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120471105 | 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 |
|---|---|---|---|
| G1166 | TX | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478131200000",
"number": "1699758664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 HOSPITAL CIR",
"address_2": "SUITE 201",
"city": "BAY CITY",
"state": "TX",
"postal_code": "774144771",
"telephone_number": "979-241-6100",
"fax_number": "979-241-6105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HOSPITAL CIR",
"address_2": "SUITE 201",
"city": "BAY CITY",
"state": "TX",
"postal_code": "774144771",
"telephone_number": "979-241-6100",
"fax_number": "979-241-6105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJU",
"first_name": "PALIVELA",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-23",
"last_updated": "2016-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "TX",
"license": "G1166",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120471105",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bay City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.