Provider Demographics
NPI:1831154921
Name:AMARASINGHAM, RUBEN (MD)
Entity type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:
Last Name:AMARASINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:PHHS, SUPPORT BLDG B, RM G106
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-7201
Mailing Address - Country:US
Mailing Address - Phone:214-590-6724
Mailing Address - Fax:214-590-4595
Practice Address - Street 1:5123 HARRY HINES BLVD
Practice Address - Street 2:PHHS SUPPORT BLDG B, RM G106
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235
Practice Address - Country:US
Practice Address - Phone:214-590-6724
Practice Address - Fax:214-590-4595
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2097207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409229500Medicaid
TX8L15910Medicare PIN
MDH61142Medicare UPIN
MD409229500Medicaid