Healthcare Provider Details

I. General information

NPI: 1740415801
Provider Name (Legal Business Name): BERNHARD SUTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 FANNIN ST PEDIATRIC NEUROLOGY DEPARTMENT
HOUSTON TX
77030-2608
US

IV. Provider business mailing address

1 BAYLOR PLZ PEDIATRIC NEUROLOGY DEPARTMENT
HOUSTON TX
77030-3411
US

V. Phone/Fax

Practice location:
  • Phone: 832-822-1764
  • Fax: 832-825-1717
Mailing address:
  • Phone: 832-822-1764
  • Fax: 832-825-1717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN9967
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberN9967
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: