MEDICARE: SURAVISION SURGERY PLLC

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	261QS0132X	Ophthalmologic Surgery Clinic/Center

General Provider Information

NPI Number	:	1902544885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURAVISION SURGERY PLLC

Provider Business Mailing Address
First Line	:	2601 WESTHEIMER RD STE C200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1662
Country	:	US
Telephone Number	:	832-605-4516
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 WESTHEIMER RD STE C200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1662
Country	:	US
Telephone Number	:	832-605-4516
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	KRISHNA SURAPANENI
Credential	:	MD
Telephone Number	:	832-605-4516

Provider Enumeration Date	:	05/22/2022
Last Update Date	:	06/11/2024

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