Healthcare Provider Details

I. General information

NPI: 1790721645
Provider Name (Legal Business Name): SUJATHA A GOLI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21212 NORTHWEST FWY STE 265
CYPRESS TX
77429-5883
US

IV. Provider business mailing address

21212 NORTHWEST FWY STE 265
CYPRESS TX
77429-5883
US

V. Phone/Fax

Practice location:
  • Phone: 281-653-9123
  • Fax: 281-653-9175
Mailing address:
  • Phone: 281-653-9123
  • Fax: 281-653-9175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberQ1822
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberQ1822
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberQ1822
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: