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General NPI Number Information
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NPI Number | 1891136925
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Entity Type | Organization
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Legal Business Name | ALEXANDER P SUDARSHAN MD PA
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 1315 E 6TH ST STE 5
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City | WESLACO
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State | TX
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Zip | 78596-6632
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Country | US
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Telephone | 956-969-3893
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Fax | 956-969-1071
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Provider Business Mailing Address
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Address Line | 1058 E LOS EBANOS BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9988
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Country | US
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Telephone | 956-541-4828
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Fax | 956-541-4568
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Authorized Official
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Title or Position | PHYSICIAN/OWER/PRESIDENT
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Name | ALEXANDER P SUDARSHAN
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Credential | MD
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Telephone | 956-541-4828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G5668
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License Number State | TX
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