Individual
SAMBASIVA RAO SUKHAVASI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 HIGHWAY 365, STE. 210, NEDERLAND, TX 77627-6256
(409) 721-5155
(409) 722-6530
Mailing address
2300 HIGHWAY 365 STE 210, NEDERLAND, TX 77627-6283
(409) 721-5155
(409) 722-6530
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
J3912
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099173901
—
TX
01
—
466904ZSRT
MEDICARE ID
TX
01
—
J3912
MEDICAL LICENSE
TX
Enumeration date
06/21/2005
Last updated
04/22/2026
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