Provider Demographics
NPI:1235166687
Name:BELAKERE, RAMEGOWDA (MD)
Entity Type:Individual
Prefix:
First Name:RAMEGOWDA
Middle Name:
Last Name:BELAKERE
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 1:18220 STATE HIGHWAY 249 STE 490
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4347
Mailing Address - Country:US
Mailing Address - Phone:281-737-0587
Mailing Address - Fax:
Practice Address - Street 1:11925 SOUTHWEST FWY STE 12
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2300
Practice Address - Country:US
Practice Address - Phone:281-741-9145
Practice Address - Fax:832-230-0875
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-00520207Q00000X
TXM7853207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193703912Medicaid