Provider Demographics
NPI:1174686364
Name:RAMAKRISHNAN, ARAVIND (MD)
Entity Type:Individual
Prefix:DR
First Name:ARAVIND
Middle Name:
Last Name:RAMAKRISHNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 FREDERICKSBURG RD
Mailing Address - Street 2:PHYSICIAN PRACTICE SERVICES
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-8105
Mailing Address - Country:US
Mailing Address - Phone:512-816-8600
Mailing Address - Fax:512-816-6171
Practice Address - Street 1:901 W BEN WHITE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-4433
Practice Address - Country:US
Practice Address - Phone:512-816-8600
Practice Address - Fax:512-816-6171
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1001207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8EM559OtherBCBS
TX8EM559OtherBCBS