Provider Demographics
NPI:1326147158
Name:RAVI, HIMA BINDU (MD)
Entity Type:Individual
Prefix:
First Name:HIMA
Middle Name:BINDU
Last Name:RAVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3516 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1316
Mailing Address - Country:US
Mailing Address - Phone:806-797-3322
Mailing Address - Fax:806-797-6622
Practice Address - Street 1:3801 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-3807
Practice Address - Country:US
Practice Address - Phone:806-725-8500
Practice Address - Fax:806-723-6611
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9158207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038476003Medicaid
45D1035264OtherCLIA
8P1101OtherBLUC CROSS BLU SHIELD
8C2215Medicare ID - Type Unspecified
TX038476003Medicaid