MADAIAH REVANA (NPI# 1013997360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013997360 |
| Entity Type | Individual |
| Full Name | MADAIAH REVANA |
| Credential | MD PA |
| Practice Address |
9950 Memorial Blvd Ste 201 Humble TX 77338 |
| Mailing Address |
9950 Memorial Blvd Ste 201 Humble TX 77338-4281 |
| Practice Telephone | 2814464638 |
| Practice Fax Number | 2814465386 |
| Mailing Telephone | 2814464638 |
| Mailing Fax Number | 2814465386 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2017-01-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
E7719 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | WELLCARE | 390396 | 01 |
| TAX ID | 742018542 | 01 | |
| BCBS | 82G136 | 01 | |
| TX | 137528912 | 05 | |
| TX | AMERIGROUP | 10016000 | 01 |
| Street Address |
9950 MEMORIAL BLVD STE 201 |
| City | HUMBLE |
| State | TX |
| Zip Code | 77338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639165129 | North Houston Respiratory Consultants Pa | Internal Medicine | 9950 Memorial Blvd, Suite 102, Humble, TX 77338-4282 | 2005-09-21 |
| 1447779590 | Melanie Domkam Fombang | Nurse Practitioner | 9950 Memorial Blvd, Humble, TX 77338-4281 | 2017-09-10 |
| 1477768141 | Madaiah Revana Md Pa | Internal Medicine | 9950 Memorial Blvd, Suite 201, Humble, TX 77338-4281 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033690 | Daniel, Max & Marcandrea, LLC | Optometrist | 9475 Fm 1960, Humble, TX 77338 | 2020-11-03 |
| 1942818240 | Karla Marize Howard | Nurse Practitioner | 18980 W. Memorial Dr. Suite 100 Plaza 2, Humble, TX 77338 | 2020-07-22 |
| 1902437981 | Houston Mint Dentistry, Pllc | Dentist | 9509 Fm 1960 Ste 200, Humble, TX 77338 | 2020-01-29 |
| 1053957514 | Sherrie Conn | Technician | 20430 Moon Walk Dr, Humble, TX 77338 | 2019-11-20 |
| 1235772450 | Madeline Rigler | Dietitian, Registered | 18980 N Memorial Dr Ste 100, Humble, TX 77338 | 2019-10-21 |
| 1982254025 | Daira Lynn Springer | Registered Nurse | 18980 W Memorial Dr., Suite 100, Humble, TX 77338 | 2019-09-19 |
| 1306494687 | Strategic Development & Instruction | Counselor | 9802 Farm To Market 1960 Bypass, Humble, TX 77338 | 2019-08-29 |
| 1124689732 | Caroline Elizabeth Le | Dentist | 9490 Farm To Market 1960 Bypass Rd W, Suite 700, Humble, TX 77338 | 2019-06-25 |
| 1699246181 | Deerbrook Asc LLC | Clinic/Center | 18450 Hwy 59 Suite 101-b, Humble, TX 77338 | 2018-12-10 |
| 1760950141 | Mckay Health Care LLC | Skilled Nursing Facility | 19279 Mckay Dr., Humble, TX 77338 | 2018-11-05 |
| Find all providers in zip 77338 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1649486168 | Rajiv Agarwal | Internal Medicine | 18980 W Memorial Dr Ste 100, Humble, TX 77338-4472 | 2007-05-14 |
| 1790715035 | Michael Pericles Siropaides I | Internal Medicine | 17903 W Lake Houston Pkwy, Ste 201, Humble, TX 77346-3954 | 2006-07-03 |
| 1497782858 | Natasha Iliskovic | Internal Medicine | 18450 Highway 59 N, Humble, TX 77338-4404 | 2006-06-28 |
| 1942267448 | Mohan Jacob | Internal Medicine | 18955 Memorial North, Suite 440, Humble, TX 77338 | 2006-04-27 |
| 1801862156 | E. John R. Samuel | Internal Medicine | 18955 N Memorial Dr Ste 200, Humble, TX 77338-4386 | 2006-02-27 |
| 1720550015 | Rajiv Agarwal Md Pa | Internal Medicine | 18980 W Memorial Dr Ste 100, Humble, TX 77338-4472 | 2018-12-26 |
| 1750795225 | Humble Cardio and Endovascular | Internal Medicine | 1475 Fm 1960 Bypass Rd E, Humble, TX 77338-3909 | 2014-06-12 |
| 1003229378 | Humble Cardiac and Endovascular | Internal Medicine | 1475 Fm 1960 Bypass Rd E, Humble, TX 77338-3909 | 2014-06-04 |
| 1609210897 | David Brian Wong | Internal Medicine | 18450 Highway 59 N, Humble, TX 77338-4404 | 2013-04-18 |
| 1700229234 | Sanjay S Lulla | Internal Medicine | 17903 W Lake Houston Pkwy Ste 201, Humble, TX 77346 | 2013-04-15 |
| Find all providers in HUMBLE | ||||
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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.