MEDICARE: DR. VYJU RAM MD, F.A.A.P.

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	208000000X	Pediatrics Physician	L9439	TX

General Provider Information

NPI Number	:	1114919651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VYJU RAM MD, F.A.A.P.

Provider Business Mailing Address
First Line	:	5610 W RIVER PARK DR
Second Line	:	SUITE A
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7901
Country	:	US
Telephone Number	:	281-494-8687
Fax Number	:	281-494-5201

Provider Business Practice Location Address
First Line	:	5610 W RIVER PARK DR
Second Line	:	SUITE A
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7901
Country	:	US
Telephone Number	:	281-494-8687
Fax Number	:	281-494-5201

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	07/08/2007

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