Provider Demographics
NPI:1134821267
Name:RAVOORI, CHERUB ISRAEL ANURAG (DPM)
Entity type:Individual
Prefix:
First Name:CHERUB
Middle Name:ISRAEL ANURAG
Last Name:RAVOORI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 S 31ST ST # MSA1202
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76508-2401
Mailing Address - Country:US
Mailing Address - Phone:414-759-6255
Mailing Address - Fax:
Practice Address - Street 1:2401 S 31ST ST # MSA1202
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-2401
Practice Address - Country:US
Practice Address - Phone:414-759-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program