Provider Demographics
NPI:1861538985
Name:KAMALSINGH M RATHOD MD
Entity type:Organization
Organization Name:KAMALSINGH M RATHOD MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KAMALSINGH
Authorized Official - Middle Name:M
Authorized Official - Last Name:RATHOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-893-1011
Mailing Address - Street 1:321 N HIGHLAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7386
Mailing Address - Country:US
Mailing Address - Phone:903-893-1011
Mailing Address - Fax:866-240-2131
Practice Address - Street 1:321 N HIGHLAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7386
Practice Address - Country:US
Practice Address - Phone:903-893-1011
Practice Address - Fax:866-240-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4690207RI0011X
TXG6377207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00BX53OtherBLUE SHIELD, TEXAS
TX081847801Medicaid
OK100755220AMedicaid
TXCN9442OtherRAIL ROAD MEDICARE PIN
TXCN9442OtherRAIL ROAD MEDICARE PIN
TX081847801Medicaid