Provider Demographics
NPI:1760011647
Name:THARMENDIRA, SIVAGOWRI (MD)
Entity Type:Individual
Prefix:DR
First Name:SIVAGOWRI
Middle Name:
Last Name:THARMENDIRA
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 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:5.138 RS
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-5302
Mailing Address - Country:US
Mailing Address - Phone:409-772-5284
Mailing Address - Fax:409-772-9785
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:5.138 RS
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-5302
Practice Address - Country:US
Practice Address - Phone:409-772-5284
Practice Address - Fax:409-772-9785
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10077469207R00000X
390200000X
TXBP20084458207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program