Healthcare Provider Details

I. General information

NPI: 1578658399
Provider Name (Legal Business Name): RAMADASS SATYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 PENNSYLVANIA AVE
FORT WORTH TX
76104-3146
US

IV. Provider business mailing address

2102 CREEKVISTA DR
KELLER TX
76248-6872
US

V. Phone/Fax

Practice location:
  • Phone: 817-321-0387
  • Fax:
Mailing address:
  • Phone: 832-868-8022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberM8317
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberM8317
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number1019016
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: