Individual
REVANTH MADINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5310 E 31ST ST, TULSA, OK 74135-5018
(918) 695-0669
Mailing address
409 SUMMER ALCOVE WAY, AUSTIN, TX 78732-1257
(512) 680-2519
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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