Individual
SUJATA SUBRAMANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0002
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036-126866
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
35138048
OH
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD425377
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
S6748
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-126866
STATE LICENSE
IL
Enumeration date
02/03/2007
Last updated
05/31/2024
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