Provider Demographics
NPI:1508271404
Name:LAKSHMIKANTH, JAYANTH KADUR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYANTH
Middle Name:KADUR
Last Name:LAKSHMIKANTH
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:PO BOX 6148
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-6148
Mailing Address - Country:US
Mailing Address - Phone:956-362-8677
Mailing Address - Fax:956-362-7253
Practice Address - Street 1:5501 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9152
Practice Address - Country:US
Practice Address - Phone:956-360-8677
Practice Address - Fax:956-362-7253
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7704207RN0300X, 207RC0200X, 207RN0300X
MI430111925207R00000X
IL125.065975390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program