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Individual

DR. DEVAKI SHILPA SUDHA SURASI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
R8279
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
392270001
TX
01
392270002
MEDICAID-CSHCN
TX
01
8KA008
BCBS
TX
01
P02163541
RAILROAD MEDICARE
TX
Enumeration date
06/24/2011
Last updated
05/18/2021
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