Individual
GREGORY CALDERONI RAVIZZINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
238724
NY
207U00000X
Nuclear Medicine Physician
Primary
P1213
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286780601
—
TX
01
—
8W5241
BCBS
TX
Enumeration date
05/10/2008
Last updated
02/27/2012
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