Provider Demographics
NPI:1285638676
Name:SOORTY, NAILA YUNUS (MD)
Entity Type:Individual
Prefix:DR
First Name:NAILA
Middle Name:YUNUS
Last Name:SOORTY
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 1:800 W SAM HOUSTON PKWY S STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-1914
Mailing Address - Country:US
Mailing Address - Phone:713-462-6565
Mailing Address - Fax:832-831-5369
Practice Address - Street 1:15555 KUYKENDAHL RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090
Practice Address - Country:US
Practice Address - Phone:713-462-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9244208000000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1550108Medicaid
LAG7577OtherBLUE CROSS/BLUE SHIELD
TX290276901Medicaid
LABK6199207OtherDEA
LAG7577OtherBLUE CROSS/BLUE SHIELD
LA1550108Medicaid
TXTXB144618Medicare PIN