Revana, Madaiah
Revana, Madaiah is an sole proprietor health care provider with primary practice located at 9950 Memorial Blvd Ste 201, Humble TX 77338. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Imaging & Therapy, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Revana, Madaiah can be contacted via phone (281) 446-4638.Contact Information
Primary practice address
9950 Memorial Blvd Ste 201
Humble TX 77338
Phone: (281) 446-4638
Fax: (281) 446-5386
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nuclear Imaging & Therapy | 207UN0902X | E7719 | Texas |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | E7719 | Texas |
Profile Details
| NPI number | 1013997360 |
|---|---|
| LBN Legal business name | Revana, Madaiah |
| Credentials | MD PA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 20th, 2006 |
| Last updated | Sep 29th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013997360 | NPPES |
| Texas | Other | 390396 | WELLCARE |
| Texas | Other | 742018542 | WELLCARE |
| Texas | MEDICAID | 137528912 | WELLCARE |
| Texas | Other | 82G136 | WELLCARE |
| Texas | Other | 10016000 | WELLCARE |
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