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Dr. Mini Sivadasan I, MD
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Dallas, Texas
NPI 1336330570

Mini Sivadasan I is a Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician based in Dallas, TX. Mini Sivadasan I practices in Dallas, TX and has the professional credentials of MD. The NPI Number for Mini Sivadasan I is 1336330570 and holds a License No. 01068886A (Texas).

The current practice location address for Mini Sivadasan I is 3430 Wheatland Rd Building 1 Suite 202, Dallas, TX and can be reached out via phone at 972-780-5888 and via fax at 972-780-5886.

Location: 3430 Wheatland Rd Building 1 Suite 202, Dallas, TX, 75237-5031
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336330570
Provider Name
Mini Sivadasan I
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
3430 Wheatland Rd Building 1 Suite 202, Dallas, TX, 75237-5031
Phone Number
972-780-5888
Fax Number
972-780-5886
Provider Enumeration Date
08/05/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1336330570 05 MI
201014710D 05 IN
201014710B 05 IN
036126598 05 IL
01618941 01 IL BLUECROSS/BLUESHIELD IL
201014710C 05 IN
1336330570 05 WI
201014710A 05 IN
201014710E 05 IN
institution
Provider Business Practice Location Address Details
Address
3430 Wheatland Rd Building 1 Suite 202
City
Dallas
State
Texas
Zip
75237-7523
Phone Number
972-780-5888
Fax Number
972-780-5886
person
Provider Business Mailing Address Details
Address
3430 Wheatland Rd Building 1 Suite 202
City
Dallas
State
Texas
Zip
75237-7523
Phone Number
972-780-5888
Fax Number
972-780-5886
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Speciality
-
Taxonomy
208G00000X
License No.
55502-20 (Wisconsin)
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
01068886A (Indiana)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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