“Geriatric Medicine (family Medicine) Physician” (Crockett, TX)
Location: Crockett, TX
Taxonomy: Geriatric Medicine (family Medicine) Physician.
A provider can have more than one taxonomy code. It is critical to register all applicable
taxonomy codes with NPPES and to use the correct taxonomy code to represent the
specific specialty when filing claims. This will assist in more accurate and timely
processing of claims.
1124013552
—
RAVI
KONIDALA
MD
Practice Location Address:
1050 E LOOP 304
SUITE 200, ETMC RURAL HEALTH CLINIC
CROCKETT TX
75835-1814
Practice Phone:
936-544-5132