Healthcare Provider Details

I. General information

NPI: 1093814501
Provider Name (Legal Business Name): RAMCHANDRA S. GURAV, M.D.P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 HOSPITAL DRIVE SUITE 2
NEW BOSTON TX
75570-2301
US

IV. Provider business mailing address

504 HOSPITAL DR SUITE 2
NEW BOSTON TX
75570-2301
US

V. Phone/Fax

Practice location:
  • Phone: 903-628-5546
  • Fax: 903-628-4023
Mailing address:
  • Phone: 903-628-5546
  • Fax: 903-628-4023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE5531
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG5916
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberE5531
License Number StateTX

VIII. Authorized Official

Name: DR. RAMCHANDRA SHANKAR GURAV
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 903-628-5546