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General NPI Number Information
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NPI Number | 1750368445
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Entity Type | Individual
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Provider Name | RADHIKA E. RAVULA MD
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Gender | Female
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Dates
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Enumeration Date | 12/23/2005
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 4708 ALLIANCE BLVD STE 850
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City | PLANO
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State | TX
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Zip | 75093-5343
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Country | US
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Telephone | 469-814-5960
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Fax |
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Provider Business Mailing Address
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Address Line | 4708 ALLIANCE BLVD STE 850
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City | PLANO
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State | TX
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Zip | 75093-5343
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Country | US
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Telephone | 469-814-5960
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | K8450
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | K8450
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | K8450
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License Number State | TX
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