Provider Demographics
NPI:1639146566
Name:THAKUR, NAVIN S (MD)
Entity Type:Individual
Prefix:
First Name:NAVIN
Middle Name:S
Last Name:THAKUR
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 1:209 GASLIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3134
Mailing Address - Country:US
Mailing Address - Phone:713-798-1750
Mailing Address - Fax:713-798-4693
Practice Address - Street 1:209 GASLIGHT BLVD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3134
Practice Address - Country:US
Practice Address - Phone:713-798-1750
Practice Address - Fax:713-798-4693
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3907208G00000X
OH35077347208G00000X
TXJ9385208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0126852000Medicaid
OH2022635Medicaid
OHP00292531OtherRR MEDICARE
PA871481PK7Medicare PIN
G17726Medicare UPIN
OH4090783Medicare PIN