Provider Demographics
NPI:1063493229
Name:IYER, SWAMINATHAN PADMANABHAN (MD)
Entity Type:Individual
Prefix:
First Name:SWAMINATHAN
Middle Name:PADMANABHAN
Last Name:IYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SWAMINATHAN
Other - Middle Name:
Other - Last Name:PADMANABHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:P O BOX 4439
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4439
Mailing Address - Country:US
Mailing Address - Phone:713-792-2991
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4009
Practice Address - Country:US
Practice Address - Phone:713-792-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002037-1207RH0003X
TXM9564207RH0003X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200008504Medicaid
TX200008510OtherCSHCN
TX8JP566OtherBCBS
TX200008503Medicaid
TX200008506Medicaid
TX200008509Medicaid
TX02499136Medicaid
TX1063493229OtherBLUE CROSS BLUE SHIELD
TX200008505Medicaid
NYI00664Medicare UPIN
TX200008506Medicaid