Provider Demographics
NPI:1578565206
Name:OM SAKTHI P.A.
Entity Type:Organization
Organization Name:OM SAKTHI P.A.
Other - Org Name:SEALY URGENT CARE CTR & MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KANNAPPAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNASWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-877-0022
Mailing Address - Street 1:1036 N CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474-3336
Mailing Address - Country:US
Mailing Address - Phone:979-877-0022
Mailing Address - Fax:979-885-3810
Practice Address - Street 1:1036 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474-3336
Practice Address - Country:US
Practice Address - Phone:979-877-0022
Practice Address - Fax:979-885-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177975301Medicaid
TX00039XMedicare PIN