Individual
MADAIAH REVANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PA
Contact information
Practice address
9816 MEMORIAL BLVD STE 107, HUMBLE, TX 77338-4205
(281) 446-4638
(281) 973-9454
Mailing address
9816 MEMORIAL BLVD, STE 107, STE 120 (TESTING), HUMBLE, TX 77338-4264
(281) 446-4638
(281) 446-5386
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
E7719
TX
207UN0902X
Nuclear Imaging & Therapy Physician
E7719
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10016000
AMERIGROUP
TX
05
—
137528912
—
TX
01
—
390396
WELLCARE
TX
01
—
742018542
TAX ID
—
01
—
82G136
BCBS
—
Enumeration date
01/20/2006
Last updated
02/03/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us