Madaiah Revana
Internist - Cardiovascular Disease
9950 Memorial Blvd Ste 201
Humble
, Texas 77338
Madaiah Revana
Internist - Cardiovascular Disease
9950 Memorial Blvd Ste 201
Humble
, Texas 77338
(281) 446-5386
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About
Features
Specialties
- Internist - Cardiovascular Disease
Languages spoken
- English
Location
First Address
- Madaiah Revana
- 9950 Memorial Blvd Ste 201
- Humble, TX
- Zip : 77338-4281
- Fax : (281) 446-5386
- Phone : (281) 446-4638
Second Address
- Madaiah Revana
- 9950 Memorial Blvd Ste 201
- Humble, TX
- Zip : 77338
- Fax : (281) 446-5386
- Phone : (281) 446-4638
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0000X | Internist - Cardiovascular Disease | E7719 | TX |
National Provider Identifier
| NPI | 1013997360 |
|---|---|
| Provider Name | Madaiah Revana |
| First Address | Humble, TX 77338-4281 |
| Second Address | Humble, TX 77338 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/01/2006 |
| Last Update Date | 04/01/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 10016000 | AMERIGROUP (01) | TX |
| 137528912 | (05) | TX |
| 390396 | WELLCARE (01) | TX |
| 742018542 | TAX ID (01) | |
| 82G136 | BCBS (01) | |
| B25894 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.