Pathikonda, Suresh N

Pathikonda, Suresh N is an individual health care provider with primary practice located at 601 E Airline Rd , Victoria TX 77901-3926. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Pathikonda, Suresh N can be contacted via phone (361) 575-8500.

Contact Information

Primary practice address
601 E Airline Rd Victoria TX 77901-3926
Fax: (361) 575-8416
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X J8083 Texas

Profile Details

NPI number 1508804121
LBN Legal business name Pathikonda, Suresh N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2006
Last updated Apr 1st, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508804121 NPPES
Texas Other 0039AZ GROUP BCBS
Texas MEDICAID 079684901 GROUP BCBS
Texas MEDICAID 127014205 GROUP BCBS
Texas MEDICAID 079684902 GROUP BCBS
Texas MEDICAID 127014203 GROUP BCBS
Texas Other 742777132 GROUP BCBS
Texas Other 88071B GROUP BCBS

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