Provider Demographics
NPI:1326394925
Name:KORANNE, KETAN PRAKASH (MD)
Entity Type:Individual
Prefix:
First Name:KETAN
Middle Name:PRAKASH
Last Name:KORANNE
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 1:13300 HARGRAVE RD STE 410
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4562
Mailing Address - Country:US
Mailing Address - Phone:281-737-0950
Mailing Address - Fax:
Practice Address - Street 1:13300 HARGRAVE RD STE 410
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4562
Practice Address - Country:US
Practice Address - Phone:281-737-0950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2145207RC0001X
IA44563207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology