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General NPI Number Information
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NPI Number | 1437258274
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Entity Type | Organization
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Legal Business Name | FAMILY DOCTORS RAMANATHAN, PLLC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 291 N PECOS RD
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City | HENDERSON
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State | NV
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Zip | 89074-1918
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Country | US
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Telephone | 702-616-9471
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Fax | 702-616-9681
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Provider Business Mailing Address
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Address Line | 291 N PECOS RD
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City | HENDERSON
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State | NV
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Zip | 89074-1918
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Country | US
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Telephone | 702-616-9471
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Fax | 702-616-9681
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Authorized Official
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Title or Position | CEO/MEDICAL DIRECTOR
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Name | RAVI S RAMANATHAN
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Credential | MD
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Telephone | 702-616-9471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9434
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License Number State | NV
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