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Individual

DR. RAVI RADHAKRISHNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
301 UNIVERSITY BLVD., GALVESTON, TX 77555-0353
(409) 772-5666
(409) 772-4253
Mailing address
301 UNIVERSITY BLVD., GALVESTON, TX 77555-0353
(409) 772-5666
(409) 772-4253

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
M0534
TX
2086S0120X
Pediatric Surgery Physician
Primary
M0534
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8U9390
BCBS
TX
01
P00452855
RAILROAD MEDICARE
TX
Enumeration date
06/20/2006
Last updated
03/30/2012
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