Organization
RAVIKUMAR KANNEGANTI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVIKUMAR KANNEGANTI M.D. (PSYCHIATRIST)
(409) 813-1765
Entity
Organization
Contact information
Practice address
3250 MEDICAL CENTER DR, BEAUMONT, TX 77701-4627
(409) 813-1765
(409) 813-1875
Mailing address
PO BOX 21313, BEAUMONT, TX 77720-1313
(409) 813-1765
(409) 813-1875
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H6867
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114668001
—
TX
Enumeration date
10/28/2010
Last updated
10/28/2010
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