Provider Demographics
NPI:1598114480
Name:THAKOR, DHVANIL (DPM)
Entity Type:Individual
Prefix:
First Name:DHVANIL
Middle Name:
Last Name:THAKOR
Suffix:
Gender:M
Credentials:DPM
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 16218
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-6218
Mailing Address - Country:US
Mailing Address - Phone:281-901-1133
Mailing Address - Fax:281-901-1601
Practice Address - Street 1:3129 KINGSLEY DR STE 640
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8508
Practice Address - Country:US
Practice Address - Phone:281-901-1133
Practice Address - Fax:281-901-1601
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2389213EP0504X, 213EP1101X, 213ER0200X, 213ES0000X, 213ES0131X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery