Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 48617 | MN |
Y | 207VE0102X | Reproductive Endocrinologist | P2240 | TX |
NPI | 1063527588 |
---|---|
Provider Name | Ravi P Gada |
First Address | Dallas, TX 75231-0946 |
Second Address | Dallas, TX 75231-0946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 31/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
332633000 | (05) | MN |
I57982 | (02) | MN |