Provider Demographics
NPI:1609883214
Name:NANDIPATY, SIVAKUMARI (MD)
Entity Type:Individual
Prefix:
First Name:SIVAKUMARI
Middle Name:
Last Name:NANDIPATY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 E 8TH ST # 1
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-5587
Mailing Address - Country:US
Mailing Address - Phone:956-973-9445
Mailing Address - Fax:956-973-0686
Practice Address - Street 1:1620 E 8TH ST # 1
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-5587
Practice Address - Country:US
Practice Address - Phone:956-973-9445
Practice Address - Fax:956-973-0686
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ92352080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120645005Medicaid
8B3211Medicare ID - Type Unspecified
TX120645005Medicaid
G13010Medicare UPIN