Provider Demographics
NPI:1164636502
Name:ASHWATH, RAVI C (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:C
Last Name:ASHWATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAVICHANDRA
Other - Middle Name:
Other - Last Name:ASWATHANARAYANAPPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:315 N SAN SABA STE 1135
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3255
Mailing Address - Country:US
Mailing Address - Phone:210-704-4275
Mailing Address - Fax:
Practice Address - Street 1:333 N SANTA ROSA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-704-8829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084551207U00000X, 2080P0202X, 2085B0100X, 2085P0229X, 2085R0202X, 2085R0204X, 2085U0001X, 2085D0003X, 2085H0002X
TXU6195208000000X, 2080P0202X
IA43728208000000X, 2080P0202X, 2085P0229X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging
No2085H0002XAllopathic & Osteopathic PhysiciansRadiologyHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000527976OtherANTHEM
OH747672OtherBUCKEYE
PA1021951190001OtherPA MEDICAID
OH2730334OtherBCMH
OH7218085OtherAETNA
OH000000221336OtherUNISON
OH363390OtherWELLCARE
OHP00411235OtherRAILROAD MEDICARE
OK200206440AOtherOK MEDICAID
OH2730334Medicaid
OH000000221336OtherUNISON