Individual
VYAS RAMUHALLI RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0177
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
14842R
LA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD14842R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1157414
—
LA
Enumeration date
05/19/2006
Last updated
02/21/2024
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