Provider Demographics
NPI:1508190935
Name:HEBBAR, SUSHMA RAMAN (MD)
Entity Type:Individual
Prefix:
First Name:SUSHMA
Middle Name:RAMAN
Last Name:HEBBAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSHMA
Other - Middle Name:
Other - Last Name:RAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 66308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266-6308
Mailing Address - Country:US
Mailing Address - Phone:832-548-5000
Mailing Address - Fax:
Practice Address - Street 1:1415 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2602
Practice Address - Country:US
Practice Address - Phone:832-548-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6018208000000X, 2080S0010X
CODR.0055243207PP0204X
NJ25MA08645000208000000X, 2080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine