Provider Demographics
NPI:1801028899
Name:ESWARAN, SRIDHAR V K (BDS, MS, MSD)
Entity Type:Individual
Prefix:DR
First Name:SRIDHAR
Middle Name:V K
Last Name:ESWARAN
Suffix:
Gender:M
Credentials:BDS, MS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6516 M D ANDERSON BLVD
Mailing Address - Street 2:SUITE # 310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3402
Mailing Address - Country:US
Mailing Address - Phone:832-623-4507
Mailing Address - Fax:713-500-4393
Practice Address - Street 1:6516 M D ANDERSON BLVD
Practice Address - Street 2:SUITE # 310
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3402
Practice Address - Country:US
Practice Address - Phone:832-623-4507
Practice Address - Fax:713-500-4393
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248471223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics