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1376864017

NPI Code Detail

MEDICARE: NANNA HELEN SULAI MD

MEDICARE: NANNA HELEN SULAI 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	207R00000X	Internal Medicine Physician	2016-01414	NC
2	207RH0000X	Hematology (Internal Medicine) Physician	2016-01414	NC
3	207RH0003X	Hematology & Oncology Physician	2016-01414	NC
4	207RX0202X	Medical Oncology Physician	2016-01414	NC
5	207RH0003X	Hematology & Oncology Physician	T1574	TX

General Provider Information

NPI Number	:	1376864017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANNA HELEN SULAI MD

Provider Business Mailing Address
First Line	:	PO BOX 911230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1242
Country	:	US
Telephone Number	:	972-997-8000
Fax Number	:	972-234-2987

Provider Business Practice Location Address
First Line	:	910 E HOUSTON ST STE 100
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75702-8363
Country	:	US
Telephone Number	:	903-579-9800
Fax Number	:	903-526-4463

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

Provider Enumeration Date	:	06/17/2010
Last Update Date	:	04/13/2022

Similar Medicare Providers

1083669246 — DR. MICHAEL DAVID WILLIAMS M.D.
Practice Location Address:

910 E HOUSTON ST STE 100
TYLER, TX
75702-8363

Practice Phone: 903-705-0072
Practice Fax: 903-705-0068

1962573378 — MR. ROBERT DUANE EPPS R.PH.
Practice Location Address:

910 E HOUSTON ST STE 100
TYLER, TX
75702-8363

Practice Phone: 903-579-9800
Practice Fax: 903-592-2811

1679825640 — MRS. AMY LYNN BRADBERY RN, FNP-C
Practice Location Address:

910 E HOUSTON ST STE 100
TYLER, TX
75702-8363

Practice Phone: 903-526-4463
Practice Fax:

1659853356 — JILL ELAINE SMITH PA-C
Practice Location Address:

910 E HOUSTON ST STE 100
TYLER, TX
75702-8363

Practice Phone: 903-579-9800
Practice Fax: 903-526-4463

1356817050 — MS. BRANDI JACKSON FNP
Practice Location Address:

910 E HOUSTON ST STE 100
TYLER, TX
75702-8363

Practice Phone: 903-579-9800
Practice Fax: 903-579-9935

1164994430 — LANE DUDO FNP-C
Practice Location Address:

910 E HOUSTON ST STE 100
TYLER, TX
75702-8363

Practice Phone: 903-606-8718
Practice Fax: 903-606-1218

Directions to “ NANNA HELEN SULAI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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