Individual
MANICKAM KUMARAVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 500-7700
(713) 704-5734
Mailing address
PO BOX 301173, DALLAS, TX 75303-1173
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
N3804
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177263401
—
TX
01
—
177263402
CSHCN
TX
01
—
8S7134
BCBS
TX
Enumeration date
06/07/2006
Last updated
08/17/2023
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