Provider Demographics
NPI:1376806810
Name:SIDDIPETA, RAMA DEVI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMA DEVI
Middle Name:
Last Name:SIDDIPETA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E UNIVERSITY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6814
Mailing Address - Country:US
Mailing Address - Phone:512-868-1124
Mailing Address - Fax:512-868-9894
Practice Address - Street 1:123 ED SCHMIDT BLVD
Practice Address - Street 2:STE 140
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-5585
Practice Address - Country:US
Practice Address - Phone:877-800-5722
Practice Address - Fax:512-846-2072
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ5573208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ5573OtherMEDICAL LICENSE
TX3481236-03Medicaid