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1730390204
SIVASANKER BAKTHAVACHALAM
PROSPER, TX
NPI
1730390204
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Other Name
SIVI BAKTHAVACHALAM
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Y00000X Otolaryngology
(Licence: TX M6033)
Enumeration Date
2007-05-25
Last Update Date
2023-05-09
Business Address
Dr. SIVASANKER BAKTHAVACHALAM M.D.
4200 W UNIVERSITY DR
PROSPER, TX 75078-9805
Phone number: 682-303-4200
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Mailing Address
Dr. SIVASANKER BAKTHAVACHALAM M.D.
PO BOX 733784
DALLAS, TX 75373-3784
Phone number: 682-885-6483
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