Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | BP20029576 | TX |
NPI | 1043540149 |
---|---|
Provider Name | Dr. Kumaran Sathyamoorthy |
First Address | Houston, TX 77030-3202 |
Second Address | Houston, TX 77030-3202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2010 |
Last Update Date | 12/01/2010 |