Provider Demographics
NPI:1720176100
Name:SRIVATHS, LAKSHMI VENKAT (MD)
Entity Type:Individual
Prefix:MRS
First Name:LAKSHMI
Middle Name:VENKAT
Last Name:SRIVATHS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAKSHMI
Other - Middle Name:
Other - Last Name:VENKATESWARAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 E GREENWAY PLZ
Mailing Address - Street 2:SUITE 900
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0297
Mailing Address - Country:US
Mailing Address - Phone:713-798-1750
Mailing Address - Fax:713-798-1144
Practice Address - Street 1:6701 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2316
Practice Address - Country:US
Practice Address - Phone:832-822-1514
Practice Address - Fax:832-825-0285
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM37792080P0207X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J2563Medicare PIN