MEDICARE: DR. PAVLINA PAJA SUCHANOVA 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	207Y00000X	Otolaryngology Physician	BP10030819	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BP10030819	OTHER	TX	PERMIT NUMBER

General Provider Information

NPI Number	:	1750603700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAVLINA PAJA SUCHANOVA M.D.

Provider Business Mailing Address
First Line	:	14140 SOUTHWEST FWY STE 200
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3842
Country	:	US
Telephone Number	:	281-649-7000
Fax Number	:	713-484-6649

Provider Business Practice Location Address
First Line	:	16545 SOUTHWEST FWY
Second Line	:	SUITE 100
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-2891
Country	:	US
Telephone Number	:	281-649-7200
Fax Number	:	281-491-6704

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

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	10/21/2019

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