MEDICARE: DR. VEENA RAMGOPAL D.O

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	OT016056	PA
2	208000000X	Pediatrics Physician	R3408	TX

General Provider Information

NPI Number	:	1053724575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VEENA RAMGOPAL D.O

Provider Business Mailing Address
First Line	:	1102 BATES AVE STE 1860
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2698
Country	:	US
Telephone Number	:	832-824-5447
Fax Number	:	832-825-0341

Provider Business Practice Location Address
First Line	:	1102 BATES AVE STE 1860
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2698
Country	:	US
Telephone Number	:	832-824-5447
Fax Number	:	832-825-0341

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2014
Last Update Date	:	11/04/2019

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