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General NPI Number Information
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NPI Number | 1053874081
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Entity Type | Individual
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Provider Name | PAVAN K NAIDU MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 3406 COLLEGE ST STE 101
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City | BEAUMONT
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State | TX
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Zip | 77701-4612
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Country | US
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Telephone | 409-813-1677
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Fax | 409-920-7093
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Provider Business Mailing Address
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Address Line | 3406 COLLEGE ST STE 200
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City | BEAUMONT
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State | TX
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Zip | 77701-4612
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Country | US
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Telephone | 409-813-1677
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Fax | 409-736-7167
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | V6366
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License Number State | TX
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