Provider Demographics
NPI:1003043928
Name:DORAI, SUPRINA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUPRINA
Middle Name:
Last Name:DORAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7911 EL DORADO DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-3010
Mailing Address - Country:US
Mailing Address - Phone:917-453-5021
Mailing Address - Fax:
Practice Address - Street 1:8721 MENCHACA RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5308
Practice Address - Country:US
Practice Address - Phone:512-280-6959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6315207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine