Basic Information
| Provider Information | |||||||||
| NPI: | 1235243379 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMADUGU | ||||||||
| FirstName: | RAJEEV | ||||||||
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| Credential: | M.B.B.S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18220 STATE HIGHWAY 249 STE 1360 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770704347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817370587 | ||||||||
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| Practice Location | |||||||||
| Address1: | 18220 STATE HIGHWAY 249 STE 1360 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817370587 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2006 | ||||||||
| LastUpdateDate: | 03/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 036131599 | IL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 036131599 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | A94292 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 01061444A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | P9939 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 036131599 | 05 | IL | MEDICAID | 343246004 | 05 | TX | MEDICAID |