Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD458483 | PA |
Y | 111NI0900X | Internist | MD458483 | PA |
N | 207RC0000X | Internist - Cardiovascular Disease | MD458483 | PA |
NPI | 1023458080 |
---|---|
Provider Name | Soumya Patnaik |
First Address | Houston, TX 77030-5389 |
Second Address | Houston, TX 77030-5389 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2013 |
Last Update Date | 07/04/2017 |