Healthcare Provider Details

I. General information

NPI: 1548558307
Provider Name (Legal Business Name): RAMANI PADMAJA PERLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 09/29/2024
Certification Date: 09/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12221 N MOPAC EXPY
AUSTIN TX
78758-2401
US

IV. Provider business mailing address

12221 N MOPAC EXPY
AUSTIN TX
78758-2401
US

V. Phone/Fax

Practice location:
  • Phone: 512-901-4009
  • Fax: 512-901-3992
Mailing address:
  • Phone: 512-901-4009
  • Fax: 512-901-3992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberQ1883
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: