Ravan Andrews, Jacquelyn Valerie

Ravan Andrews, Jacquelyn Valerie is an individual health care provider with primary practice located at 5323 Harry Hines Blvd , Dallas TX 75390. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgical Oncology, which is considered as her primary health care specialty. Ravan Andrews, Jacquelyn Valerie can be contacted via phone (214) 645-0624.

Contact Information

Primary practice address
5323 Harry Hines Blvd Dallas TX 75390
Fax: (214) 645-0078
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X K1341 Texas

Profile Details

NPI number 1912963893
LBN Legal business name Ravan Andrews, Jacquelyn Valerie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Sep 29th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912963893 NPPES
Texas MEDICAID 100666003

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