Provider Demographics
NPI:1093723777
Name:SARVI, MAYGOL (DO)
Entity Type:Individual
Prefix:DR
First Name:MAYGOL
Middle Name:
Last Name:SARVI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-4997
Mailing Address - Fax:
Practice Address - Street 1:3350 NE LOOP 286
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-3440
Practice Address - Country:US
Practice Address - Phone:903-785-0031
Practice Address - Fax:903-784-6755
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN60002085R0001X
IL336-0702632085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036109243Medicaid
TX363548402Medicaid
TX363548401Medicaid
TX363548401Medicaid
TX310395YQCCMedicare PIN
TX310395YKYCMedicare PIN