Healthcare Provider Details

I. General information

NPI: 1801949342
Provider Name (Legal Business Name): ARAVINDA KURELLA RAO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444A PADDOCK LN
HOUMA LA
70360-2490
US

IV. Provider business mailing address

7698 GOODWOOD BLVD
BATON ROUGE LA
70806-7622
US

V. Phone/Fax

Practice location:
  • Phone: 985-333-4090
  • Fax:
Mailing address:
  • Phone: 225-927-8141
  • Fax: 225-927-3024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number026058
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD.026058
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: