Individual
DR. SUJAN GOGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1000 E DOVE AVE STE 200, MCALLEN, TX 78504-3974
(956) 362-3530
(956) 362-3531
Mailing address
PO BOX 4624, MCALLEN, TX 78502-4624
(956) 362-3530
(956) 362-3531
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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