Provider Demographics
NPI:1568791010
Name:YALAMURI, RAVI KANTH REDDY (MD)
Entity Type:Individual
Prefix:
First Name:RAVI KANTH
Middle Name:REDDY
Last Name:YALAMURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1643 NW 136TH AVE BLDG H
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3091
Mailing Address - Country:US
Mailing Address - Phone:954-835-2841
Mailing Address - Fax:865-560-7110
Practice Address - Street 1:4917 RAVENSWOOD DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-4317
Practice Address - Country:US
Practice Address - Phone:210-568-3410
Practice Address - Fax:865-560-7110
Is Sole Proprietor?:No
Enumeration Date:2009-12-11
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT196206207R00000X
TXP4132207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine