Provider Demographics
NPI:1962484907
Name:RAMSHESH, PRIYA VENGU (MD)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:VENGU
Last Name:RAMSHESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17183 INTERSTATE 45 S STE 110
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3313
Mailing Address - Country:US
Mailing Address - Phone:936-270-3480
Mailing Address - Fax:936-270-3479
Practice Address - Street 1:17183 INTERSTATE 45 S
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3312
Practice Address - Country:US
Practice Address - Phone:936-270-3480
Practice Address - Fax:936-270-3479
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM-1304207RH0003X
TXM1304207RH0003X, 207R00000X, 207RH0003X
IN01091285A207R00000X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177735102Medicaid
TX177735101Medicaid
TX177735102Medicaid
TX177735102Medicaid