Provider Demographics
NPI:1447319512
Name:NAIK, NIRAVKUMAR A (MD)
Entity type:Individual
Prefix:DR
First Name:NIRAVKUMAR
Middle Name:A
Last Name:NAIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NIRAV
Other - Middle Name:A
Other - Last Name:NAIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3602 ABBEYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5900
Mailing Address - Country:US
Mailing Address - Phone:404-840-6794
Mailing Address - Fax:
Practice Address - Street 1:4021 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3160
Practice Address - Country:US
Practice Address - Phone:281-420-7211
Practice Address - Fax:281-420-7206
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5604207R00000X, 207RX0202X, 207RH0003X
WAMD61088975207R00000X, 207RH0000X, 207RH0003X, 207RX0202X
WI51703-20207RH0003X
NC2021-00253207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100023768Medicaid
NC1447319512Medicaid