Healthcare Provider Details

I. General information

NPI: 1629719281
Provider Name (Legal Business Name): SUMA GANJI ANGIREKULA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST # 270-6
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

22931 CARDIGAN CHASE
SAN ANTONIO TX
78260-4071
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-7882
  • Fax: 713-500-0758
Mailing address:
  • Phone: 954-292-7684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberV0398
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: