Individual
RAVIKUMAR VEMURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 E 5TH ST, ODESSA, TX 79761-5133
(432) 333-3433
(432) 333-3450
Mailing address
315 E 5TH ST, ODESSA, TX 79761-5133
(432) 333-3433
(432) 333-3450
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J5044
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080701802
—
TX
01
—
100012089
RAILROAD MEDICARE
TX
01
—
126089100
FIRSTCARE
TX
01
—
U8947
MEDICAID
NM
Enumeration date
08/16/2006
Last updated
09/30/2011
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