Dr. Kathy Ravanbakhsh, D.O.
Urology in Bryan, TX. Individual provider (NPI-1).
NPI number1790739167
StatusActive
Last updated in NPPESDec 3, 2012
Details
- NPI
- 1790739167
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kathy Ravanbakhsh
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 20, 2006
- Last updated
- Dec 3, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - UROLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | M8941 | TX | Yes |
| 208800000X | Urology | 036-110986 | IL |
Practice location
2700 E 29th St Ste 100Bryan, TX 77802-2507
Phone 979-774-3041 · Fax 979-774-3053
Mailing address
2700 E 29th St Ste 100Bryan, TX 77802-2507
Phone 979-774-3041 · Fax 979-774-3053
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 9 Urology Physician providers in Bryan · All 1,947 providers in Bryan
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