# RAVI K. MOOTHA, M.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** North Texas Urology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063653376
- **Authorized official:** DR. RAVI KANTH MOOTHA M.D. (PRESIDENT)
- **Authorized official phone:** (214) 514-8480

## Contact information

- **Practice address:** 2821 E PRESIDENT GEORGE BUSH HWY, SUITE 305, RICHARDSON, TX 75082-4266
- **Practice address phone:** (972) 235-3248
- **Practice address fax:** (972) 235-3984
- **Mailing address:** 2821 E PRESIDENT GEORGE BUSH HWY, SUITE 305, RICHARDSON, TX 75082-4266
- **Mailing address phone:** (972) 235-3248
- **Mailing address fax:** (972) 235-3984

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | L7054 | TX | Yes |

## Other

- **Enumeration date:** 03/16/2009
- **Last updated:** 09/20/2009