Individual
RAVINDRA MOHAN BHARADWAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5939 HARRY HINES BLVD 8TH FLOOR STE HQ08.124, DALLAS, TX 75390-1786
(214) 645-8650
Mailing address
PO BOX 845347 PO BOX 845347, DALLAS, TX 75284-7298
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01056005A
IN
207R00000X
Internal Medicine Physician
43992
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
43992
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
44727
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
Q2739
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01056005A
STATE LICENSURE
IN
05
—
200425170A
—
IN
05
—
20447390 A
—
OK
05
—
303346601
—
TX
05
—
303346602
—
TX
05
—
75152835
—
NM
Enumeration date
02/13/2006
Last updated
03/07/2023
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