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General NPI Number Information
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NPI Number | 1255429395
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Entity Type | Individual
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Provider Name | SRIRAMAMURTHY SUBBARAMAN M.D., F.A.C.S
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 4214 ANDREWS HWY STE 208
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City | MIDLAND
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State | TX
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Zip | 79703-4868
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Country | US
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Telephone | 432-689-3503
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Fax | 432-689-3553
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Provider Business Mailing Address
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Address Line | PO BOX 1408
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City | BIG SPRING
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State | TX
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Zip | 79721-1408
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Country | US
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Telephone | 432-689-3503
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Fax | 432-689-3553
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G7354
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License Number State | TX
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