Individual
GEETHA SUBRAMANIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4800 N GALLOWAY AVE, SUITE 100, MESQUITE, TX 75150-1176
(972) 270-6368
Mailing address
4800 N GALLOWAY AVE, SUITE 100, MESQUITE, TX 75150-1176
(972) 270-6368
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M7666
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193139601
—
TX
01
—
8AW050
BCBS PROVIDER #
TX
Enumeration date
04/25/2007
Last updated
06/18/2021
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