MEDICARE: SUPARNA SAHA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	BP20036196	TX

General Provider Information

NPI Number	:	1174770945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUPARNA SAHA MD

Provider Business Mailing Address
First Line	:	110 GRAY ST
Second Line	:	APT 2159
City	:	HOUSTON
State	:	TX
Zip	:	77002-8500
Country	:	US
Telephone Number	:	510-386-0468
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 GRAY ST
Second Line	:	APT 3155
City	:	HOUSTON
State	:	TX
Zip	:	77002-8500
Country	:	US
Telephone Number	:	713-523-0900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2008
Last Update Date	:	10/28/2010

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