MEDICARE: DOMINIC GREGORY SRESHTA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	L0617	TX
2	207R00000X	Internal Medicine Physician	L0617	TX

General Provider Information

NPI Number	:	1760486179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIC GREGORY SRESHTA M.D.

Provider Business Mailing Address
First Line	:	16701 CREEK BEND DR # 500
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3395
Country	:	US
Telephone Number	:	281-265-0409
Fax Number	:	281-265-0402

Provider Business Practice Location Address
First Line	:	16701 CREEK BEND DR # 500
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3395
Country	:	US
Telephone Number	:	281-265-0409
Fax Number	:	281-265-0402

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	05/15/2024

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