Provider Demographics
NPI:1346968344
Name:PANDAY, SURAJAN (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:SURAJAN
Middle Name:
Last Name:PANDAY
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N LAKELINE BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-6780
Mailing Address - Country:US
Mailing Address - Phone:512-379-7272
Mailing Address - Fax:
Practice Address - Street 1:1201 N LAKELINE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6780
Practice Address - Country:US
Practice Address - Phone:512-379-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX722303163WC0200X
TXAP1101061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine