Individual
DR. RADHIKA E. RAVULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4708 ALLIANCE BLVD STE 850, PLANO, TX 75093-5343
(469) 814-5960
Mailing address
4708 ALLIANCE BLVD, STE 850, PLANO, TX 75093-5343
(469) 814-5960
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
K8450
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
K8450
TX
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
K8450
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101180103
—
TX
05
—
101180104
—
TX
05
—
101180105
—
TX
01
—
720000337
RAILROAD
TX
01
—
8G2125
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/23/2005
Last updated
05/24/2022
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