Provider Demographics
NPI:1881664142
Name:MOPARTY, RAVI KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:KUMAR
Last Name:MOPARTY
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 1:26103 INTERSTATE 45
Mailing Address - Street 2:SUITE 100
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1902
Mailing Address - Country:US
Mailing Address - Phone:281-583-5000
Mailing Address - Fax:281-583-5099
Practice Address - Street 1:26103 INTERSTATE 45
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1902
Practice Address - Country:US
Practice Address - Phone:281-583-5000
Practice Address - Fax:281-583-5099
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2481207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164155701Medicaid
TX164155701Medicaid
TX609905Medicare PIN