Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 220508 | MA |
N | 208600000X | Surgeon | 220508 | MA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 0101252034 | VA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | R0576 | TX |
NPI | 1144308164 |
---|---|
Provider Name | Ravi K. Ghanta |
First Address | Houston, TX 77030-3411 |
Second Address | Houston, TX 77030-1608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 09/03/2017 |