Provider Demographics
NPI:1891996005
Name:SUBRAMANIAM RAMANATHAN MDPA
Entity Type:Organization
Organization Name:SUBRAMANIAM RAMANATHAN MDPA
Other - Org Name:SUBRAM,ANIAM RAMANATHAN MDPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUBRAMANIAM
Authorized Official - Middle Name:VENKATRAMAN
Authorized Official - Last Name:RAMANATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-548-0090
Mailing Address - Street 1:SUBRAMANIAM RAMANATHAN
Mailing Address - Street 2:303 NORTH MCKINEEY STREET
Mailing Address - City:SWEENY
Mailing Address - State:TX
Mailing Address - Zip Code:77480
Mailing Address - Country:US
Mailing Address - Phone:979-548-0090
Mailing Address - Fax:979-548-0095
Practice Address - Street 1:SUBRAMANIAM RAMANATHAN
Practice Address - Street 2:303 NORTH MCKINEEY STREET
Practice Address - City:SWEENY
Practice Address - State:TX
Practice Address - Zip Code:77480
Practice Address - Country:US
Practice Address - Phone:979-548-0090
Practice Address - Fax:979-548-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0624207P00000X
TXMO624207R00000X
TXMO0624207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty