MEDICARE: DR. KANDASAMI SENTHILKUMAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	L1740	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811990369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KANDASAMI SENTHILKUMAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 12685
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77726-2685
Country	:	US
Telephone Number	:	409-838-4338
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 HOSPITAL DR STE 100
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77701-4663
Country	:	US
Telephone Number	:	409-838-4338
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2005
Last Update Date	:	09/25/2024

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