Individual
ANITA RAVIPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1751 WALLACE BLVD, AMARILLO, TX 79106-1711
(806) 212-4673
(806) 212-0057
Mailing address
PO BOX 840048, DALLAS, TX 75284-0048
(806) 212-5079
(806) 212-6278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301081421
MI
207RH0003X
Hematology & Oncology Physician
Primary
N5963
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
269056YNR6
MEDICARE
TX
05
—
281630802
—
TX
Enumeration date
07/28/2006
Last updated
12/07/2021
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