Individual
JOTHI A SUKKAWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
700 SCOTT AND WHITE DR, COLLEGE STATION, TX 77845-6441
(979) 207-0100
(979) 207-2161
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M3758
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183140602
—
TX
Enumeration date
05/03/2006
Last updated
07/23/2024
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