Provider Demographics
NPI:1427251867
Name:DESIKAN, KAMALAKANNAN (MD)
Entity type:Individual
Prefix:
First Name:KAMALAKANNAN
Middle Name:
Last Name:DESIKAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DESIKAN
Other - Middle Name:
Other - Last Name:KAMALAKANNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20710 WESTHEIMER PKWY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6064
Mailing Address - Country:US
Mailing Address - Phone:281-646-9000
Mailing Address - Fax:281-206-2311
Practice Address - Street 1:20710 WESTHEIMER PKWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6064
Practice Address - Country:US
Practice Address - Phone:281-646-9000
Practice Address - Fax:281-206-2311
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5143207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5291892OtherCIGNA
TX0080WBOtherBCBS TX
FLME104516OtherSTATE MEDICAL LICENSE
TXN5143OtherSTATE MEDICAL LICENSE TX