Individual
NANDKISHORE B RAGHURAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 WALLACE BLVD, 2ND FLOOR, PICU, AMARILLO, TX 79106
(806) 212-6965
(806) 212-6278
Mailing address
PO BOX 840026, DALLAS, TX 75284-0026
(806) 212-5079
(806) 212-6278
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
K6254
TX
2080P0203X
Pediatric Critical Care Medicine Physician
51588
WI
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
K6254
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177246904
—
TX
Enumeration date
05/31/2005
Last updated
09/29/2023
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