=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326294745
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAPIL H THAKKAR M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2008
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8088 HAWKS RD
-----------------------------------------------------
City | LEESVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71446-6649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-462-8880
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1776 WOODSTEAD CT STE 208
-----------------------------------------------------
City | THE WOODLANDS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77380-1480
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-749-7428
-----------------------------------------------------
Fax | 480-305-2889
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 205565
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | MD.205565
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------