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Divya Seetharam Rajan

Pediatrics

Allopathic & Osteopathic Physicians

1935 Medical District Dr, Dallas, TX 75235-7701

PECOS Enrollment

This provider is enrolled in PECOS as DIVYA RAJAN.

Based on the most recent information from CMS, provider Divya Seetharam Rajan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 10:37 AM.

Profile Details

Provider ID
1992029466
Provider Type
Individual
Full Name
Rajan, Divya Seetharam
Credential
MD PHD

Gender
Female
Sole Proprietor
No
Enumeration Date
3/26/2010
Last Updated
4/4/2019

Contact Information

Practice Location

1935 Medical District Dr, Dallas, TX 75235-7701

(214) 456-0488

(214) 456-4486

Mailing Location

1935 Medical District Dr, Dallas, TX 75235-7701

(214) 456-0488

(214) 456-4486

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License P6702 Texas
Code 2080N0001X	Description Pediatrics Allopathic & Osteopathic Physicians	License P6702 Texas
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Divya Seetharam Rajan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Abdallah, Bayan

Reggiardo, Diana B.

Sanchez, Maria Josefina

Squiers, William Baldwin

Varnet, Marie E

Flores, Adolfo

Mack, Ashley

Trost, Margaret J

Escalante, Mirna

Van Der Laan, Lyndsey Kari