Provider Demographics
NPI:1629647417
Name:RAM BONAM PLLC
Entity Type:Organization
Organization Name:RAM BONAM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:BONAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-607-1349
Mailing Address - Street 1:2509 80TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2217
Mailing Address - Country:US
Mailing Address - Phone:866-656-7398
Mailing Address - Fax:806-771-0033
Practice Address - Street 1:1310 BUCKINGHAM AVE
Practice Address - Street 2:
Practice Address - City:WOLFFORTH
Practice Address - State:TX
Practice Address - Zip Code:79382-3220
Practice Address - Country:US
Practice Address - Phone:916-607-1349
Practice Address - Fax:707-261-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty