MEDICARE: ALEX M SU 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	207Q00000X	Family Medicine Physician	K7912	TX

General Provider Information

NPI Number	:	1609871706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX M SU MD

Provider Business Mailing Address
First Line	:	PO BOX 392929
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9900
Country	:	US
Telephone Number	:	713-461-2915
Fax Number	:	713-461-5307

Provider Business Practice Location Address
First Line	:	9055 KATY FWY
Second Line	:	STE 200
City	:	HOUSTON
State	:	TX
Zip	:	77024-1624
Country	:	US
Telephone Number	:	713-461-2915
Fax Number	:	713-461-5307

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	03/20/2023

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