Provider Demographics
NPI:1003075664
Name:BORRA, RAVI C (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:C
Last Name:BORRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 NORTHBROOK LANE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707
Mailing Address - Country:US
Mailing Address - Phone:432-262-3880
Mailing Address - Fax:
Practice Address - Street 1:4712 NORTHBROOK LANE
Practice Address - Street 2:SUITE B1
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707
Practice Address - Country:US
Practice Address - Phone:432-262-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-08
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5937207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism