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21308 Provincial Blvd Katy TX 77450-7580 | |
| (281) 206-8201 | |
| (281) 206-8206 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 21308 Provincial Blvd, Katy, Texas |
| Authorized Official Name and Position | Ramana Surya (OWNER) |
| Authorized Official Contact | 2812068201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
21308 Provincial Blvd Katy TX 77450-7580 Ph: (281) 206-8201 | 21308 Provincial Blvd Katy TX 77450-7580 Ph: (281) 206-8201 |
| NPI Number | 1992074033 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 03/09/2012 |
| Medicare PECOS PAC ID | 9436311123 |
|---|---|
| Medicare Enrollment ID | O20120425000291 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992074033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | L1473 (Texas) | Primary |
| Provider Name | Ramana G Surya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144260621 PECOS PAC ID: 6002957438 Enrollment ID: I20100107000682 |
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