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Individual
DR. SIVAREVATHI THAKUR
Active
Individual
DR. SIVAREVATHI THAKUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N5431
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283104201
—
TX
05
—
283104202
—
TX
05
—
283104203
—
TX
05
—
283104204
—
TX
05
—
283104205
—
TX
05
—
283104207
—
TX
05
—
283104208
—
TX
05
—
283104209
—
TX
01
—
8CU881
BCBS
TX
Enumeration date
05/07/2007
Last updated
12/04/2012
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