MEDICARE: J SUBRAMANIAN MD PLLC

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	208VP0014X	Interventional Pain Medicine Physician	L9920	TX

General Provider Information

NPI Number	:	1568512515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J SUBRAMANIAN MD PLLC

Provider Business Mailing Address
First Line	:	4325 N JOSEY LN
Second Line	:	PLAZA III STE.206
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4635
Country	:	US
Telephone Number	:	972-939-7246
Fax Number	:	972-394-0293

Provider Business Practice Location Address
First Line	:	4325 N JOSEY LN
Second Line	:	PLAZA III STE.206
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4635
Country	:	US
Telephone Number	:	972-939-7246
Fax Number	:	972-394-0293

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	DR. JOYSREE SUBRAMANIAN
Credential	:	MD
Telephone Number	:	972-939-7246

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	12/15/2011

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