MEDICARE: DR. RAMAN MOCHARLA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1043292154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMAN MOCHARLA MD

Provider Business Mailing Address
First Line	:	12219 BROKEN ARROW ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4214
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12219 BROKEN ARROW ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4214
Country	:	US
Telephone Number	:	713-935-9895
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	07/24/2007

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Directions to “ DR. RAMAN MOCHARLA MD” Practice Location

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