Individual
MARISA SUPPATKUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11000 RICHMOND AVE, SUITE 330, HOUSTON, TX 77042-4776
(713) 974-0879
Mailing address
4916 SPRUCE ST, BELLAIRE, TX 77401-4026
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M2831
TX
2084P0804X
Child & Adolescent Psychiatry Physician
M2831
TX
Other
Enumeration date
03/26/2007
Last updated
09/11/2025
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