Provider Demographics
NPI:1265757892
Name:SWAMINATH, DEEPHAK
Entity type:Individual
Prefix:
First Name:DEEPHAK
Middle Name:
Last Name:SWAMINATH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 AUBURN ST
Mailing Address - Street 2:APT 531
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-1454
Mailing Address - Country:US
Mailing Address - Phone:806-789-3556
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-6840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS1520207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology