Organization
SAMBASIVA R SUKHAVASI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMBASIVA SUKHAVASI M.D. (M.D.)
(409) 721-5155
Entity
Organization
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 77627-6256
(409) 721-5155
(409) 722-6530
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099173901
—
TX
01
—
466900
MEDICARE ID
TX
Enumeration date
11/30/2015
Last updated
03/02/2016
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