Provider Demographics
NPI:1225120801
Name:SURAPANENI, SRI NAVEEN (MD, MPH)
Entity Type:Individual
Prefix:
First Name:SRI NAVEEN
Middle Name:
Last Name:SURAPANENI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4052
Mailing Address - Country:US
Mailing Address - Phone:281-480-6264
Mailing Address - Fax:281-480-4046
Practice Address - Street 1:1015 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 1700
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4052
Practice Address - Country:US
Practice Address - Phone:281-480-6264
Practice Address - Fax:281-480-4046
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI48602-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine