Healthcare Provider Details

I. General information

NPI: 1326294745
Provider Name (Legal Business Name): KAPIL H THAKKAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8088 HAWKS RD
LEESVILLE LA
71446-6649
US

IV. Provider business mailing address

1776 WOODSTEAD CT STE 208
THE WOODLANDS TX
77380-1480
US

V. Phone/Fax

Practice location:
  • Phone: 337-462-8880
  • Fax:
Mailing address:
  • Phone: 877-749-7428
  • Fax: 480-305-2889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number205565
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD.205565
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: