1023392156 NPI number — MS. VARSHA RAM PA-C

Table of content: MS. VARSHA RAM PA-C (NPI 1023392156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023392156 NPI number — MS. VARSHA RAM PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAM
Provider First Name:
VARSHA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023392156
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21540 PROVINCIAL BLVD APT 928
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KATY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77450-7529
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-877-0022
Provider Business Mailing Address Fax Number:
979-885-3810

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1036 N CIRCLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEALY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77474-3336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-877-0022
Provider Business Practice Location Address Fax Number:
989-885-3810
Provider Enumeration Date:
10/07/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA07378 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)