Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | Q1001 | TX |
NPI | 1174686364 |
---|---|
Provider Name | Dr. Aravind Ramakrishnan |
First Address | San Antonio, TX 78229-8105 |
Second Address | Austin, TX 78704-4433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 26/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8EM559 | BCBS (01) | TX |