Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | P7592 | TX |
NPI | 1053623546 |
---|---|
Provider Name | Dr. Ram Raj Vasudevan |
First Address | Austin, TX 78746-5226 |
Second Address | Austin, TX 78746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2010 |
Last Update Date | 07/09/2016 |