Provider Demographics
NPI:1972506236
Name:KUMAR, VIJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:
Last Name:KUMAR
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 1:2929 CALDER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1845
Mailing Address - Country:US
Mailing Address - Phone:409-833-9797
Mailing Address - Fax:409-839-3174
Practice Address - Street 1:3570 COLLEGE ST
Practice Address - Street 2:SUITE 130
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4683
Practice Address - Country:US
Practice Address - Phone:409-833-9797
Practice Address - Fax:409-654-6917
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5797207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156848703Medicaid
TX156848701Medicaid
8F6682Medicare PIN
TX156848701Medicaid
TXH76708Medicare UPIN