Basic Information
Provider Information
NPI: 1508113515
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMIREDDY
FirstName: SRINIVAS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6400 FANNIN ST STE 1400
Address2:  
City: HOUSTON
State: TX
PostalCode: 770301512
CountryCode: US
TelephoneNumber: 7137043450
FaxNumber: 7137049938
Practice Location
Address1: 6400 FANNIN ST STE 1400
Address2:  
City: HOUSTON
State: TX
PostalCode: 77030
CountryCode: US
TelephoneNumber: 7137043450
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/08/2012
LastUpdateDate: 09/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100XR7090TXY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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