Provider Demographics
NPI:1659665305
Name:RADHAKRISHNAN, GEETHA LAKSHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:GEETHA
Middle Name:LAKSHMI
Last Name:RADHAKRISHNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GEETHA
Other - Middle Name:LAKSHMI
Other - Last Name:RAMASWAMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:UTMB CHILDREN'S HOSPITAL 3.230
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0354
Mailing Address - Country:US
Mailing Address - Phone:409-747-0534
Mailing Address - Fax:409-747-0721
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:UTMB CHILDREN'S HOSPITAL 3.230
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0354
Practice Address - Country:US
Practice Address - Phone:409-747-0534
Practice Address - Fax:409-747-0721
Is Sole Proprietor?:No
Enumeration Date:2011-05-29
Last Update Date:2011-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0040962208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics