Provider Demographics
NPI:1811949290
Name:YOGANANDAN, PRAMEELA (MD)
Entity type:Individual
Prefix:
First Name:PRAMEELA
Middle Name:
Last Name:YOGANANDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16655 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2329
Mailing Address - Country:US
Mailing Address - Phone:432-923-1961
Mailing Address - Fax:
Practice Address - Street 1:5111 WEATHERSTONE CIR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4282
Practice Address - Country:US
Practice Address - Phone:432-923-1961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0995207PE0004X, 207QA0505X, 207Q00000X
TXMO995207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176754327Medicaid
TX176754325Medicaid
TX176754324Medicaid
TX176754326Medicaid
TXTXB164085Medicare PIN
TX176754324Medicaid
TXP01103147Medicare PIN
TXH23473Medicare UPIN
TX176754326Medicaid
TXTXB163352Medicare PIN
TX176754327Medicaid