Individual
POONGODHAI RAMACHANDRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1002 TEXAS BLVD, SUITE 401, TEXARKANA, TX 75501-5107
(903) 794-8820
(903) 794-8878
Mailing address
1002 TEXAS BLVD, SUITE 401, TEXARKANA, TX 75501-5107
(903) 794-8820
(903) 794-8878
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L9046
TX
207RC0000X
Cardiovascular Disease Physician
Primary
L9046
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171419802
—
TX
01
—
81962S
BCBS
TX
Enumeration date
05/27/2006
Last updated
11/20/2015
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