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General NPI Number Information
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NPI Number | 1811191497
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Entity Type | Individual
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Provider Name | JAGADHEESWARI NONESUPPLIED RAMACHANDRAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 12221 N MOPAC EXPY
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City | AUSTIN
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State | TX
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Zip | 78758-2401
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Country | US
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Telephone | 512-901-4009
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Fax | 512-901-3909
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Provider Business Mailing Address
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Address Line | 12221 N MOPAC EXPY
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City | AUSTIN
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State | TX
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Zip | 78758-2401
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Country | US
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Telephone | 512-901-4479
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Fax | 512-901-3945
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M8934
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License Number State | TX
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