MEDICARE: DR. MANGALA M RAMAMURTHY M.D.

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	207R00000X	Internal Medicine Physician	J4977	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386626968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANGALA M RAMAMURTHY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 627
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78599-0627
Country	:	US
Telephone Number	:	956-631-3982
Fax Number	:	956-631-0254

Provider Business Practice Location Address
First Line	:	1200 E RIDGE RD
Second Line	:	SUITE 7
City	:	MCALLEN
State	:	TX
Zip	:	78503-1527
Country	:	US
Telephone Number	:	956-631-3982
Fax Number	:	956-631-0254

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	10/14/2011

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