Healthcare Provider Details

I. General information

NPI: 1811736200
Provider Name (Legal Business Name): RAVI PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4616 US HWY 75 # 203
DENISON TX
75020-4513
US

IV. Provider business mailing address

PO BOX 468
SHANNON AL
35142-0468
US

V. Phone/Fax

Practice location:
  • Phone: 903-841-4454
  • Fax:
Mailing address:
  • Phone: 888-212-4243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: YASIR LAL
Title or Position: PRESIDENT
Credential: MD
Phone: 605-521-6506