Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | R2421 | TX |
NPI | 1629231337 |
---|---|
Provider Name | Dr. Surya Mundluru |
First Address | Houston, TX 77030-1526 |
Second Address | Katy, TX 77450-5898 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 09/11/2018 |