Provider Demographics
NPI:1093079717
Name:RAMA K RAO
Entity Type:Organization
Organization Name:RAMA K RAO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMA
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-224-9091
Mailing Address - Street 1:234 SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1119
Mailing Address - Country:US
Mailing Address - Phone:210-224-9091
Mailing Address - Fax:210-224-2424
Practice Address - Street 1:234 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1119
Practice Address - Country:US
Practice Address - Phone:210-224-9091
Practice Address - Fax:210-224-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8626207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035384901Medicaid
TXF48154Medicare UPIN
TX035384901Medicaid