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Individual

DR. SUJAN GOGU

Active
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Individual

DR. SUJAN GOGU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
R0401
TX
208VP0014X
Interventional Pain Medicine Physician
R0401
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1N6372
PTAN
TX
01
731012
MEDICARE
TX
Enumeration date
05/28/2014
Last updated
10/19/2023
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