Provider Demographics
NPI:1548464118
Name:KUMAR, SWATI SHARMA (MBBS)
Entity type:Individual
Prefix:DR
First Name:SWATI
Middle Name:SHARMA
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MBBS
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 155838
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-5838
Mailing Address - Country:US
Mailing Address - Phone:936-634-4422
Mailing Address - Fax:936-634-4424
Practice Address - Street 1:409 GASLIGHT BLVD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3132
Practice Address - Country:US
Practice Address - Phone:936-634-4422
Practice Address - Fax:936-634-4424
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9434207RR0500X
TXBP2-0025829207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX356203ZHHVMedicare PIN