Provider Demographics
NPI:1962512673
Name:GOEL, RAVINDRA HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:RAVINDRA
Middle Name:HOWARD
Last Name:GOEL
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 1:1402 MAGNOLIA RDG
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-5042
Mailing Address - Country:US
Mailing Address - Phone:318-741-9995
Mailing Address - Fax:318-212-5755
Practice Address - Street 1:2520 BERT KOUNS INDUSTRIAL LOOP
Practice Address - Street 2:SUITE 105B
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3130
Practice Address - Country:US
Practice Address - Phone:318-212-5750
Practice Address - Fax:318-212-5755
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021336207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine