Healthcare Provider Details

I. General information

NPI: 1720175797
Provider Name (Legal Business Name): RAMA LAXMAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RAMASAMY LAKSHMANAN MD

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 01/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 WOODSTEAD CT STE 101
THE WOODLANDS TX
77380-1450
US

IV. Provider business mailing address

1776 WOODSTEAD CT STE 101
THE WOODLANDS TX
77380-1450
US

V. Phone/Fax

Practice location:
  • Phone: 281-419-6466
  • Fax: 281-419-6470
Mailing address:
  • Phone: 281-419-6466
  • Fax: 281-681-6470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK 6073
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: