Provider Demographics
NPI:1487124327
Name:MR YERRAMADHA MD
Entity type:Organization
Organization Name:MR YERRAMADHA MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MURALIDHAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:YERRAMADHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-221-2321
Mailing Address - Street 1:1514 FROST CREEK LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4682
Mailing Address - Country:US
Mailing Address - Phone:224-238-9801
Mailing Address - Fax:
Practice Address - Street 1:560 BLOSSOM ST STE C
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4237
Practice Address - Country:US
Practice Address - Phone:832-905-6141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty