Provider Demographics
NPI:1255382404
Name:SIVAKUMAR, ANUPAMA (MD)
Entity type:Individual
Prefix:MRS
First Name:ANUPAMA
Middle Name:
Last Name:SIVAKUMAR
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 1:3318 HIGHWAY 365
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-7832
Mailing Address - Country:US
Mailing Address - Phone:409-727-1717
Mailing Address - Fax:409-293-3736
Practice Address - Street 1:3318 HIGHWAY 365
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-7832
Practice Address - Country:US
Practice Address - Phone:409-727-1717
Practice Address - Fax:409-293-3736
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN66712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTBX107650Medicare PIN