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General NPI Number Information
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NPI Number | 1184625063
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Entity Type | Individual
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Provider Name | VIJAY KUMAR KRISHNAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 3420 FANNIN ST SUITE 190
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City | BEAUMONT
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State | TX
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Zip | 77701-3809
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Country | US
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Telephone | 409-838-0411
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Fax | 409-838-9032
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Provider Business Mailing Address
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Address Line | PO BOX 5312
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City | BEAUMONT
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State | TX
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Zip | 77726-5312
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Country | US
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Telephone | 409-838-0411
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Fax | 409-838-9032
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | H8712
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License Number State | TX
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