MEDICARE: SURESH M. ROONGTA M.D.

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	282N00000X	General Acute Care Hospital	F2426	TX

General Provider Information

NPI Number	:	1609057306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURESH M. ROONGTA M.D.

Provider Business Mailing Address
First Line	:	6624 FANNIN ST STE 1440
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2326
Country	:	US
Telephone Number	:	713-791-9119
Fax Number	:	713-791-9199

Provider Business Practice Location Address
First Line	:	6624 FANNIN ST STE 1440
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2326
Country	:	US
Telephone Number	:	713-791-9119
Fax Number	:	713-791-9199

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. SURESH M ROONGTA
Credential	:	M.D.
Telephone Number	:	713-791-9119

Provider Enumeration Date	:	11/21/2007
Last Update Date	:	10/08/2008

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