Provider Demographics
NPI:1104089036
Name:PINGALI, SAI RAVI KIRAN (MD)
Entity type:Individual
Prefix:
First Name:SAI RAVI KIRAN
Middle Name:
Last Name:PINGALI
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 1:18101 POINT LOOKOUT DR
Mailing Address - Street 2:APT 476
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3569
Mailing Address - Country:US
Mailing Address - Phone:630-215-6707
Mailing Address - Fax:
Practice Address - Street 1:6445 MAIN ST
Practice Address - Street 2:OPC FLOOR 24
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1502
Practice Address - Country:US
Practice Address - Phone:713-441-2813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0341207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology