Provider Demographics
NPI:1700069184
Name:KANDASAMI SENTHILKUMAR, MD PA
Entity Type:Organization
Organization Name:KANDASAMI SENTHILKUMAR, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KANDASAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SENTHILKUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-838-4338
Mailing Address - Street 1:PO BOX 12685
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77726-2685
Mailing Address - Country:US
Mailing Address - Phone:409-838-4338
Mailing Address - Fax:409-838-1488
Practice Address - Street 1:740 HOSPITAL DR
Practice Address - Street 2:100
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4664
Practice Address - Country:US
Practice Address - Phone:409-838-4338
Practice Address - Fax:409-838-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty