Individual
RAVIKUMAR KANNEGANTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3250 MEDICAL CENTER DR, BEAUMONT, TX 77701-4627
(409) 813-1765
(409) 813-1875
Mailing address
PO BOX 21313, BEAUMONT, TX 77720-1313
(409) 813-1765
(409) 813-1875
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
H6867
TX
2084P0804X
Child & Adolescent Psychiatry Physician
H6867
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114668001
—
TX
Enumeration date
11/09/2006
Last updated
01/06/2020
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