DR. RAVI BOTLA (NPI# 1366540544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366540544 |
| Entity Type | Individual |
| Full Name | DR. RAVI BOTLA |
| Credential | M.D. |
| Practice Address |
621 Camden Street Suite 202 San Antonio TX 78215-1639 |
| Mailing Address |
Po Box 75235 Dallas TX 75235-0629 |
| Practice Telephone | 2102533422 |
| Practice Fax Number | 2102279833 |
| Mailing Telephone | 2144242200 |
| Mailing Fax Number | 2142312159 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2017-02-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
J7912 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE - RAILROAD | 930072561 | 01 |
| TX | 136549604 | 05 | |
| TX | BC/BS | 87500S | 01 |
| Street Address |
621 CAMDEN STREET SUITE 202 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78215-1639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275631525 | Komaranahalli P. Ganeshappa | Internal Medicine | 621 Camden Street, San Antonio, TX 78215-1639 | 2006-09-20 |
| 1649488222 | Jan Carlos Prazak | Internal Medicine | 621 Camden Street, Suite 202, San Antonio, TX 78215-1639 | 2007-05-18 |
| 1235237595 | Hector D. Allende | Internal Medicine | 621 Camden Street, San Antonio, TX 78215-1639 | 2006-09-20 |
| 1457459695 | Ravi L. Ganeshappa | Internal Medicine | 621 Camden Street, San Antonio, TX 78215-1639 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710487780 | Webster Street Dental Pllc | Clinic/Center | 311 E Jones Ave, San Antonio, TX 78215 | 2018-02-16 |
| 1699215293 | Monique Gonzalez | Nurse Practitioner | 311 Camden St., Suite 510, San Antonio, TX 78215 | 2017-03-01 |
| 1477958015 | Rachel Lynn Stein | Nurse Practitioner | 311 Camden St Ste 501, San Antonio, TX 78215 | 2014-10-24 |
| 1962837005 | Jessica Maria Leighton | Nurse Practitioner | 926 Brooklyn Ave Ste 100, San Antonio, TX 78215 | 2013-09-09 |
| 1891037123 | Michael Aguilar Davila | Clinic/Center | 303 E Quincy Ste 104, Physician Health Services, San Antonio, TX 78215 | 2013-03-25 |
| 1265669584 | Colin Townes Son | Neurological Surgery | 123 Roy Smith St Apt 1211, San Antonio, TX 78215 | 2009-06-12 |
| 1306082292 | Dario Fernandez | Physical Therapist | 302 E Josephine St Ste 1101, San Antonio, TX 78215 | 2008-12-23 |
| 1992966584 | Vcphcs Vii, LLC | Clinic/Center | 519 E. Quincy, San Antonio, TX 78215 | 2008-06-17 |
| 1871686360 | Inocencio A. Davila, M.d.,p.a. | Anesthesiology | 621 N. Alamo, San Antonio, TX 78215 | 2006-10-02 |
| 1730282708 | Elizabeth S Brickman | Pediatrics | 311 Camden, Suite 214, San Antonio, TX 78215 | 2006-09-06 |
| Find all providers in zip 78215 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174188718 | Kesar Family Pllc | Internal Medicine | 3303 Rodgers Road, Suite 250, San Antonio, TX 78251 | 2019-05-09 |
| 1740611177 | Christie L Mannino | Internal Medicine | 19284 Stone Oak Pkwy Ste 102, San Antonio, TX 78258-3474 | 2013-12-11 |
| 1457549032 | Desh Bandhu Sharma | Internal Medicine | 3303 Rodgers Rd, Suite 250, San Antonio, TX 78251 | 2007-10-09 |
| 1912082355 | Joycelyn Marie Theard | Internal Medicine | 3338 Oak Well Ct, # 205, San Antonio, TX 78218 | 2006-10-26 |
| 1548350598 | Seema A Dar | Internal Medicine | 19284 Stone Oak Pkwy, Suite 102, San Antonio, TX 78258-3473 | 2006-10-13 |
| 1942390901 | Seema A Dar, Md Pa | Internal Medicine | 19284 Stone Oak Parkway, Suite 102, San Antonio, TX 78258-3474 | 2006-10-13 |
| 1275631525 | Komaranahalli P. Ganeshappa | Internal Medicine | 621 Camden Street, San Antonio, TX 78215-1639 | 2006-09-20 |
| 1174551766 | Fred F Poordad | Internal Medicine | 607 Camden St Ste 108, San Antonio, TX 78215 | 2006-06-30 |
| 1396799847 | Maria Rita Lepe Suastegui | Internal Medicine | 607 Camden St, Suite 101, San Antonio, TX 78215 | 2006-05-20 |
| 1558328302 | Victor S Ostrower | Internal Medicine | 8201 Ewing Halsell Dr, 2nd Flr., San Antonio, TX 78229-3707 | 2006-04-26 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78215 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.