Individual
VIVEK SHREEDHARA RAMARATHNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 COLLEGE AVE, FORT WORTH, TX 76104-3013
(817) 810-9810
(817) 810-9815
Mailing address
PO BOX 162464, FORT WORTH, TX 76161-2464
(817) 810-9810
(817) 810-9815
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
N4687
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8DK236
BCBS
TX
Enumeration date
07/23/2007
Last updated
11/08/2018
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