Provider Demographics
NPI:1194724567
Name:LAKSHMANAN, KARUPPANA GOUNDAR (MD)
Entity type:Individual
Prefix:
First Name:KARUPPANA
Middle Name:GOUNDAR
Last Name:LAKSHMANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7853
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77726
Mailing Address - Country:US
Mailing Address - Phone:409-838-0411
Mailing Address - Fax:409-838-9032
Practice Address - Street 1:3420 FANNIN ST
Practice Address - Street 2:SUITE 180
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701
Practice Address - Country:US
Practice Address - Phone:409-838-0411
Practice Address - Fax:409-838-9032
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8029207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B24206Medicare UPIN
TX00EK22Medicare ID - Type Unspecified