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General NPI Number Information
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NPI Number | 1790950483
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Entity Type | Individual
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Provider Name | SURESH JOSEPH VALLOPPILLIL M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 5204 SILVER LAKE DR
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City | PLANO
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State | TX
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Zip | 75093-7564
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Country | US
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Telephone | 214-699-9297
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 112
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City | MUNCIE
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State | IN
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Zip | 47308-0112
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Country | US
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Telephone | 800-745-5156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | N3366
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License Number State | TX
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