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NPI Code Detail

MEDICARE: PRIYA SUREJA PHARMD

MEDICARE: PRIYA SUREJA PHARMD
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
1183500000XPharmacist61004TX

General Provider Information

NPI Number : 1720503303
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRIYA SUREJA PHARMD
Provider Business Mailing Address
First Line : 14806 WILLANCY CT
Second Line :
City : HOUSTON
State : TX
Zip : 77095-3076
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2508 S DAY ST
Second Line :
City : BRENHAM
State : TX
Zip : 77833-5521
Country : US
Telephone Number : 979-277-0906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2017
Last Update Date : 08/04/2017

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Directions to “ PRIYA SUREJA PHARMD” Practice Location

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