Provider Demographics
NPI:1104892959
Name:AMARA, RAMESH (MD)
Entity type:Individual
Prefix:
First Name:RAMESH
Middle Name:
Last Name:AMARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12950 DALLAS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4235
Mailing Address - Country:US
Mailing Address - Phone:972-377-8695
Mailing Address - Fax:972-377-8699
Practice Address - Street 1:12950 DALLAS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4235
Practice Address - Country:US
Practice Address - Phone:972-377-8695
Practice Address - Fax:972-377-8699
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8489207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1927262204Medicaid
NY02290655Medicaid
TX1927262205Medicaid
TX197262209Medicaid
TX197262201Medicaid
TX197262206Medicaid
TXTXB123153Medicare PIN
TXTXB118449Medicare PIN
TXTXB118448Medicare PIN
TX197262201Medicaid
TX1927262204Medicaid
NYDD2065Medicare ID - Type Unspecified
TXTXB118441Medicare PIN