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Ravi K. Ghanta

Thoracic Surgery (Cardiothoracic Vascular Surgery)

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as RAVI GHANTA.

Based on the most recent information from CMS, provider Ravi K. Ghanta is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1144308164
Provider Type
Individual
Full Name
Ghanta, Ravi K.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
11/1/2006
Last Updated
3/9/2017

Contact Information

Practice Location

1504 Taub Loop, Houston, TX 77030-1608

(713) 873-3417

Unlisted Fax

Mailing Location

1 Baylor Plz # Mc390, Houston, TX 77030-3411

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208G00000X Primary	Description Thoracic Surgery (Cardiothoracic Vascular Surgery) Allopathic & Osteopathic Physicians	License R0576 Texas
Code 208600000X	Description Surgery Allopathic & Osteopathic Physicians	License 220508 Massachusetts
Code 208G00000X	Description Thoracic Surgery (Cardiothoracic Vascular Surgery) Allopathic & Osteopathic Physicians	License 0101252034 Virginia

Ravi K. Ghanta

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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