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Individual
DR. RAVI V PACHIGOLLA
Active
Individual
DR. RAVI V PACHIGOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
K4763
TX
207YX0602X
Otolaryngic Allergy Physician
K4763
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Z738
MEDICARE GROUP PIN
TX
01
—
198437901
MEDICAID GROUP
TX
05
—
198438701
—
TX
01
—
K4763
TX LICENSE
TX
Enumeration date
09/23/2005
Last updated
04/28/2022
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