Provider Demographics
NPI:1215622279
Name:RAVIKUMAR, SHRIMATHI (APRN)
Entity type:Individual
Prefix:MS
First Name:SHRIMATHI
Middle Name:
Last Name:RAVIKUMAR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 SANDY CV
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-4326
Mailing Address - Country:US
Mailing Address - Phone:337-936-5098
Mailing Address - Fax:
Practice Address - Street 1:16401 1ST ST
Practice Address - Street 2:
Practice Address - City:SPLENDORA
Practice Address - State:TX
Practice Address - Zip Code:77372-4026
Practice Address - Country:US
Practice Address - Phone:281-968-4096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1114743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily