Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | M5530 | TX |
NPI | 1356515829 |
---|---|
Provider Name | Sarat Chandra Susarla |
First Address | Houston, TX 77024-2420 |
Second Address | Houston, TX 77024-2420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 12/03/2012 |