Provider Demographics
NPI:1124482740
Name:SABAPATHY, KARTHIK (DO)
Entity type:Individual
Prefix:DR
First Name:KARTHIK
Middle Name:
Last Name:SABAPATHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 E STATE HIGHWAY 114 STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5251
Mailing Address - Country:US
Mailing Address - Phone:817-502-7411
Mailing Address - Fax:
Practice Address - Street 1:1110 E STATE HIGHWAY 114 STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-5251
Practice Address - Country:US
Practice Address - Phone:817-502-7411
Practice Address - Fax:817-502-7412
Is Sole Proprietor?:No
Enumeration Date:2016-04-09
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS020213208100000X
TXT09132081P2900X, 208VP0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program