Provider Demographics
NPI:1093814501
Name:RAMCHANDRA S. GURAV, M.D.P.A.
Entity Type:Organization
Organization Name:RAMCHANDRA S. GURAV, M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMCHANDRA
Authorized Official - Middle Name:SHANKAR
Authorized Official - Last Name:GURAV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-628-5546
Mailing Address - Street 1:504 HOSPITAL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NEW BOSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75570-2301
Mailing Address - Country:US
Mailing Address - Phone:903-628-5546
Mailing Address - Fax:903-628-4023
Practice Address - Street 1:504 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 2
Practice Address - City:NEW BOSTON
Practice Address - State:TX
Practice Address - Zip Code:75570-2301
Practice Address - Country:US
Practice Address - Phone:903-628-5546
Practice Address - Fax:903-628-4023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5531207Q00000X, 207VG0400X
TXG5916208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1114480-01Medicaid
TX1114480-04Medicaid
TX1139735-01Medicaid
TX00AC57Medicare ID - Type Unspecified
TX1114480-04Medicaid