Provider Demographics
NPI:1982864229
Name:RAMAKRISHNA PEMMARAJU RAO,M.D.PA
Entity Type:Organization
Organization Name:RAMAKRISHNA PEMMARAJU RAO,M.D.PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMA
Authorized Official - Middle Name:PEMMARAJU
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-551-1008
Mailing Address - Street 1:1600 N REDBUD BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3235
Mailing Address - Country:US
Mailing Address - Phone:214-551-1008
Mailing Address - Fax:
Practice Address - Street 1:1600 N REDBUD BLVD STE 207
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3235
Practice Address - Country:US
Practice Address - Phone:214-551-1008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0060NROtherBCBS
TX0060NROtherBCBS