Provider Demographics
NPI:1356462873
Name:BOUAJRAM, RAMI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMI
Middle Name:
Last Name:BOUAJRAM
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 1:6363 PINTAIL LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-2290
Mailing Address - Country:US
Mailing Address - Phone:310-597-0032
Mailing Address - Fax:469-301-2420
Practice Address - Street 1:2301 MARSH LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8497
Practice Address - Country:US
Practice Address - Phone:310-597-0032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6185207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214355401Medicaid
TXP00843048OtherRAILROAD MEDICARE
TX752616977042OtherTRICARE
TX8V3855OtherBCBS
TXP00843048OtherRAILROAD MEDICARE