Individual
SHIYAMALI SUNDARARAJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12319 N MOPAC EXPY STE 160, AUSTIN, TX 78758-2648
(512) 222-5721
Mailing address
529 CADDO LAKE DR, GEORGETOWN, TX 78628-7137
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
39852
TX
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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