Provider Demographics
NPI:1275610586
Name:RAVER, CATHERINE ANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ANNETTE
Last Name:RAVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3500 GASTON AVE
Mailing Address - Street 2:4 ROBERTS
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2017
Mailing Address - Country:US
Mailing Address - Phone:214-820-3000
Mailing Address - Fax:214-820-3022
Practice Address - Street 1:3500 GASTON AVE
Practice Address - Street 2:4 ROBERTS
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2017
Practice Address - Country:US
Practice Address - Phone:214-820-3000
Practice Address - Fax:214-820-3022
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM5490207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G0897OtherBCBS
TX8CZ851OtherBCBSTX
TX188029601Medicaid
TX188029602Medicaid
TX188029601Medicaid
TXI67188Medicare UPIN
TXTXB132512Medicare PIN
TX8J0122Medicare PIN