Provider Demographics
NPI:1144260621
Name:SURYA, RAMANA (DO)
Entity type:Individual
Prefix:
First Name:RAMANA
Middle Name:
Last Name:SURYA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24530 KINGSLAND BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3429
Mailing Address - Country:US
Mailing Address - Phone:832-321-5180
Mailing Address - Fax:832-321-4497
Practice Address - Street 1:24530 KINGSLAND BLVD STE B
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3429
Practice Address - Country:US
Practice Address - Phone:832-321-5180
Practice Address - Fax:832-321-4497
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL14732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152004102Medicaid
PA1416438OtherPA BLUE SHIELD
PAH65680Medicare UPIN
PAP00016403OtherMEDICARE RAILROAD
PA50000133OtherCAPITAL BLUE CROSS
PA059437Medicare PIN
PA2117482OtherCIGNA BEHAVIORAL HEALTH
PA218028OtherMAMSI
PA542913000OtherMAGELLAN
PA001903730Medicaid
PA465464OtherVALUE OPTIONS