Basic Information
Provider Information
NPI: 1225323397
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEHARA
FirstName: RAMAKRISHNA
MiddleName: VENKATA
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 6139
Address2:  
City: MCALLEN
State: TX
PostalCode: 785026139
CountryCode: US
TelephoneNumber: 9563622171
FaxNumber: 9563622132
Practice Location
Address1: 5520 LEONARDO DA VINCI
Address2: STE 100
City: EDINBURG
State: TX
PostalCode: 785391422
CountryCode: US
TelephoneNumber: 9563623636
FaxNumber: 9563622699
Other Information
ProviderEnumerationDate: 06/16/2011
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X125:060256ILN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0100XR2282TXY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


Home