Provider Demographics
NPI:1750370995
Name:VARIYAM, EASWARAN PUTHUKODE (MD)
Entity type:Individual
Prefix:DR
First Name:EASWARAN
Middle Name:PUTHUKODE
Last Name:VARIYAM
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 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0764
Mailing Address - Country:US
Mailing Address - Phone:409-772-1501
Mailing Address - Fax:409-772-4789
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0764
Practice Address - Country:US
Practice Address - Phone:409-772-1501
Practice Address - Fax:409-772-4789
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67416207RG0100X
TXL7612207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX041857601Medicaid
TX20125905OtherDPS
TX84341ZOtherHMO BLUE
NMA032OtherTRIWEST
TX041857602Medicaid
NM64117Medicaid
NM64117OtherPRESBYTERIAN COMMERICAL
TX8A3060OtherBC/BS
OK100219540AMedicaid
TX126029100OtherFRISTCARE COMMERCIAL
TX126029101Medicaid
NM67386814Medicaid
NM67386814Medicaid
TX041857602Medicaid
NM64117OtherPRESBYTERIAN COMMERICAL
TX126029101Medicaid