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General NPI Number Information
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NPI Number | 1457647950
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Entity Type | Organization
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Legal Business Name | SURESH K.J. BABU MD., PA
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 350 HIGHWAY 290 E SUITE 5
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City | HEMPSTEAD
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State | TX
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Zip | 77445-5571
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Country | US
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Telephone | 979-826-8833
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Fax | 979-826-9469
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Provider Business Mailing Address
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Address Line | PO BOX 1382
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City | CYPRESS
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State | TX
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Zip | 77410-1382
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Country | US
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Telephone | 979-826-8833
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Fax | 979-826-9469
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Authorized Official
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Title or Position | PRESIDENT
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Name | SURESH BABU
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Credential | MD
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Telephone | 979-826-8833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K0622
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License Number State | TX
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