Provider Demographics
NPI:1871684928
Name:VENKATARAMAN, SRIVIDYA (MD)
Entity Type:Individual
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First Name:SRIVIDYA
Middle Name:
Last Name:VENKATARAMAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2811 DUKE OF GLOUCESTER ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115
Mailing Address - Country:US
Mailing Address - Phone:972-274-5555
Mailing Address - Fax:972-274-5663
Practice Address - Street 1:2811 DUKE OF GLOUCESTER ST
Practice Address - Street 2:SUITE 103
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115
Practice Address - Country:US
Practice Address - Phone:972-274-5555
Practice Address - Fax:972-274-5663
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2011-08-25
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Provider Licenses
StateLicense IDTaxonomies
TXM3104207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology