MEDICARE: AVINASH RAVIPATI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	C1-0023832	DE
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	33839	OK
3	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	W1216	TX

General Provider Information

NPI Number	:	1528444379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVINASH RAVIPATI MD

Provider Business Mailing Address
First Line	:	2423 WILLIAMS DR STE 107
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78628-3269
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 N A W GRIMES BLVD STE N202
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-3540
Country	:	US
Telephone Number	:	877-800-5722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2015
Last Update Date	:	03/26/2026

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