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General NPI Number Information
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NPI Number | 1265711683
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Entity Type | Organization
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Legal Business Name | SUJA PILLI MD PA
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 08/16/2011
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Provider Practice Location Address
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Address Line | 1706 N ED CAREY DR SUITE B
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City | HARLINGEN
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State | TX
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Zip | 78550-8351
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Country | US
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Telephone | 956-622-3157
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Fax | 956-622-3409
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Provider Business Mailing Address
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Address Line | 2224 S 77 SUNSHINESTRIP STE 96 PMB # 206
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City | HARLINGEN
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State | TX
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Zip | 78550-8310
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Country | US
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Telephone | 956-622-3157
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Fax | 956-622-3409
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | SUJA PERAKATHU PILLI
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Credential | M.D.
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Telephone | 956-622-3157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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