Individual
RAVI SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2640 183RD ST, HOMEWOOD, IL 60430-2914
(708) 798-6633
(708) 798-6790
Mailing address
2855 GRAMERCY ST STE 400, HOUSTON, TX 77025-1697
(713) 668-6828
(713) 668-3823
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036172784
IL
207W00000X
Ophthalmology Physician
S6038
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
411508105
—
TX
Enumeration date
06/25/2016
Last updated
01/28/2025
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