Provider Demographics
NPI:1396043055
Name:SIVAGNANAM, KAMESH (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMESH
Middle Name:
Last Name:SIVAGNANAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 PEASE ST STE 406
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8338
Mailing Address - Country:US
Mailing Address - Phone:956-966-6255
Mailing Address - Fax:
Practice Address - Street 1:2121 PEASE ST STE 406
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8338
Practice Address - Country:US
Practice Address - Phone:956-389-5677
Practice Address - Fax:956-698-4953
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6654207RC0000X
TN56141207RC0000X
RIMD19501207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program