Dr. Pasam Sudershan Rao
Gastroenterologist
1107 Audubon Ave A
Thibodaux
, Louisiana 70301-4940
Dr. Pasam Sudershan Rao
Gastroenterologist
1107 Audubon Ave A
Thibodaux
, Louisiana 70301-4940
(985) 447-7003
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About
Features
Specialties
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Dr. Pasam Sudershan Rao
- 103 Allendale Dr
- Thibodaux, LA
- Zip : 70301-8031
- Fax : (985) 447-7003
- Phone : (985) 447-7004
Second Address
- Dr. Pasam Sudershan Rao
- 1107 Audubon Ave A
- Thibodaux, LA
- Zip : 70301-4940
- Fax : (985) 447-7003
- Phone : (985) 447-7004
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0100X | Gastroenterologist | 12265R | LA |
National Provider Identifier
| NPI | 1023152063 |
|---|---|
| Provider Name | Dr. Pasam Sudershan Rao |
| First Address | Thibodaux, LA 70301-8031 |
| Second Address | Thibodaux, LA 70301-4940 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/02/2007 |
| Last Update Date | 28/09/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1534994 | (05) | LA |
| G58729 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.