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NPI Code Detail

MEDICARE: DR. NITHIN SURESH M.D.

MEDICARE: DR. NITHIN SURESH 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
1207QA0505XAdult Medicine Physician04-43811KS
2390200000XStudent in an Organized Health Care Education/Training Program

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1S9233OTHERTXTX LICENSE

General Provider Information

NPI Number : 1881126811
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NITHIN SURESH M.D.
Provider Business Mailing Address
First Line : 2115 KRAMER LN STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78758-4196
Country : US
Telephone Number : 512-978-8449
Fax Number :
Provider Business Practice Location Address
First Line : 825 E RUNDBERG LN STE B1
Second Line :
City : AUSTIN
State : TX
Zip : 78753-4860
Country : US
Telephone Number : 512-978-9600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2017
Last Update Date : 02/10/2026

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Directions to “ DR. NITHIN SURESH M.D.” Practice Location

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