Healthcare Provider Details

I. General information

NPI: 1467408963
Provider Name (Legal Business Name): RAMESH P VASANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date: 10/03/2019
Reactivation Date: 12/04/2019

III. Provider practice location address

1553 HWY 34 SOUTH STE 200
TERRELL TX
75160
US

IV. Provider business mailing address

PO BOX 893
TERRELL TX
75160-0014
US

V. Phone/Fax

Practice location:
  • Phone: 972-563-2678
  • Fax: 972-551-6977
Mailing address:
  • Phone: 972-563-2678
  • Fax: 972-551-6977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberF6145
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: