Healthcare Provider Details

I. General information

NPI: 1275794752
Provider Name (Legal Business Name): ARJUNA KUPERAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9230 KATY FREEWAY SUITE 600
HOUSTON TX
77055-7434
US

IV. Provider business mailing address

9230 KATY FREEWAY SUITE 600
HOUSTON TX
77055-7434
US

V. Phone/Fax

Practice location:
  • Phone: 713-791-0700
  • Fax: 713-791-0703
Mailing address:
  • Phone: 713-791-0700
  • Fax: 713-791-0703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME115036
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberQ0955
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: