Ravi Konidala
Family Doctor Family Doctor - Geriatric Medicine
1050 E Loop 304 Suite 200, Etmc Rural Health Clinic
Crockett
, Texas 75835-1814
Ravi Konidala
Family Doctor Family Doctor - Geriatric Medicine
1050 E Loop 304 Suite 200, Etmc Rural Health Clinic
Crockett
, Texas 75835-1814
(936) 544-8029
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About
Features
Specialties
- Family Doctor
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Ravi Konidala
- 511 Heath St
- Crockett, TX
- Zip : 75835-2290
- Fax : (936) 544-8029
- Phone : (936) 204-0600
Second Address
- Ravi Konidala
- 1050 E Loop 304 Suite 200, Etmc Rural Health Clinic
- Crockett, TX
- Zip : 75835-1814
- Fax : (936) 544-8029
- Phone : (936) 544-5132
Reviews
FAQs
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What type of doctor is Ravi Konidala
In what state does Ravi Konidala practice in?
Where is Ravi Konidala ’s practice located?
What is Ravi Konidala ’s gender?
Is Ravi Konidala a sole practitioner?
Is Ravi Konidala accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | M6981 | TX |
| N | 207QG0300X | Family Doctor - Geriatric Medicine | M6981 | TX |
National Provider Identifier
| NPI | 1124013552 |
|---|---|
| Provider Name | Ravi Konidala |
| First Address | Crockett, TX 75835-2290 |
| Second Address | Crockett, TX 75835-1814 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/09/2005 |
| Last Update Date | 02/06/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1010424560001 | (05) | PA |
| I09028 | (02) | PA |
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.