DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. SIVASANKER BAKTHAVACHALAM, M.D.

Active

Otolaryngology · PROSPER, TX

Registration Details

NPI Number
1730390204
Provider Type
Individual
Gender
Male
NPI Issued
May 25, 2007 (18.916818606631 yrs)
Last Updated
May 9, 2023
License
M6033 (TX)

Practice Information

Address
4200 W UNIVERSITY DR
PROSPER, TX, 750789805
Browse TX providers · Browse ZIP 75078
Phone
6823034200
Fax
6823034242
Primary Specialty
Otolaryngology
207Y00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.