MEDICARE: SUSAN SOMOGYI JARRELL 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	207Q00000X	Family Medicine Physician	K7773	TX

General Provider Information

NPI Number	:	1912298308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN SOMOGYI JARRELL M.D.

Provider Business Mailing Address
First Line	:	11511 SHADOW CREEK PKWY
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7298
Country	:	US
Telephone Number	:	713-442-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	146 E HOSPITAL DR STE 102
Second Line	:
City	:	ANGLETON
State	:	TX
Zip	:	77515-4170
Country	:	US
Telephone Number	:	979-864-3034
Fax Number	:

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

Provider Enumeration Date	:	04/20/2011
Last Update Date	:	05/07/2021

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