1811144025 NPI number — BALA RAMANAN M.B.B.S.

NPI Number: 1811144025
Health Care Provider/Practitioner: BALA RAMANAN M.B.B.S.

NPI Number : 1811144025 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811144025",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RAMANAN",
    "FirstName": "BALA",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.B.B.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "660 BANNOCK ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DENVER",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80204-4506",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "402-707-7066",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5325 HARRY HINES BLVD # MC9157",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75390-2202",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "402-707-7066",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/19/2008",
    "LastUpdateDate": "03/13/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2086S0129X",
          "TaxonomyName": "Vascular Surgery Physician",
          "LicenseNumber": "DR.0072761",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2086S0129X",
          "TaxonomyName": "Vascular Surgery Physician",
          "LicenseNumber": "A127676",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}