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General NPI Number Information
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NPI Number | 1295991271
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Entity Type | Individual
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Provider Name | RAVIKUMAR R ANTHONY BDS,MDS
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Gender | Male
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 7703 FLOYD CURL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3901
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Country | US
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Telephone | 484-574-5031
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40397
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City | SAN ANTONIO
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State | TX
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Zip | 78229-1397
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Country | US
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Telephone | 484-574-5031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 24070
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License Number State | TX
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