Organization
SUBRA ANANDASIVAM MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBRA ANANDASIVAM MD (MD)
(956) 548-2242
Entity
Organization
Contact information
Practice address
64 S PRICE RD, STE A, BROWNSVILLE, TX 78521-2459
(956) 548-2242
(956) 548-2262
Mailing address
64 S PRICE RD, STE A, BROWNSVILLE, TX 78521-2459
(956) 548-2242
(956) 548-2262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L5222
TX
207RN0300X
Nephrology Physician
Primary
K0605
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030566601
—
TX
05
—
156202701
—
TX
Enumeration date
02/17/2009
Last updated
11/16/2011
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