Provider Demographics
NPI:1912071465
Name:LAKSHMANAN, RAMASWAMY (MD)
Entity type:Individual
Prefix:DR
First Name:RAMASWAMY
Middle Name:
Last Name:LAKSHMANAN
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 1:3560 DELAWARE ST
Mailing Address - Street 2:SUITE 1103
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3067
Mailing Address - Country:US
Mailing Address - Phone:409-899-2623
Mailing Address - Fax:409-899-1155
Practice Address - Street 1:3560 DELAWARE ST
Practice Address - Street 2:SUITE 1103
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3067
Practice Address - Country:US
Practice Address - Phone:409-899-2623
Practice Address - Fax:409-899-1155
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH87162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1146896-02Medicaid
TX00F89MMedicare ID - Type Unspecified
TX1146896-02Medicaid