Provider Demographics
NPI:1629302344
Name:DR R S P A
Entity Type:Organization
Organization Name:DR R S P A
Other - Org Name:VCARE HOME VISITING PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROOPAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHYAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-666-8515
Mailing Address - Street 1:3400 SILVERSTONE DR
Mailing Address - Street 2:STE 123
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-7873
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 SILVERSTONE DR
Practice Address - Street 2:STE 123
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7873
Practice Address - Country:US
Practice Address - Phone:214-988-5447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty