| Hima B Ravi, M.d., P.a. | |
|
8212 Ithaca Ave Ste E1 Lubbock TX 79423-2633 | |
| (806) 771-1386 | |
| (806) 771-1388 |
| Full Name | Hima B Ravi, M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 8212 Ithaca Ave Ste E1, Lubbock, Texas |
| Authorized Official Name and Position | Zinda West (OFFICE MANAGER) |
| Authorized Official Contact | 8067711386 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hima B Ravi, M.d., P.a. Po Box 54136 Lubbock TX 79453-4136 Ph: (806) 771-1386 | Hima B Ravi, M.d., P.a. 8212 Ithaca Ave Ste E1 Lubbock TX 79423-2633 Ph: (806) 771-1386 |
| NPI Number | 1700530052 |
|---|---|
| Provider Enumeration Date | 02/07/2022 |
| Last Update Date | 02/07/2022 |
| Medicare PECOS PAC ID | 6709270689 |
|---|---|
| Medicare Enrollment ID | O20220221000073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700530052 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Traci Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659301471 PECOS PAC ID: 6709775570 Enrollment ID: I20040311000655 |
| Provider Name | Hima B Ravi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326147158 PECOS PAC ID: 8921075235 Enrollment ID: I20040916000185 |
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