Provider Demographics
NPI:1972099166
Name:THANGAVELU, MALARVIZHI (MD)
Entity Type:Individual
Prefix:
First Name:MALARVIZHI
Middle Name:
Last Name:THANGAVELU
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 1:601 E AIRLINE RD
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3926
Mailing Address - Country:US
Mailing Address - Phone:210-763-6307
Mailing Address - Fax:
Practice Address - Street 1:601 E AIRLINE RD
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3926
Practice Address - Country:US
Practice Address - Phone:361-575-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT0952208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics