Provider Demographics
NPI:1598853327
Name:SETH, SURESH CHANDRA (MD)
Entity Type:Individual
Prefix:MR
First Name:SURESH
Middle Name:CHANDRA
Last Name:SETH
Suffix:
Gender:M
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:PO BOX 4340
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78853
Mailing Address - Country:US
Mailing Address - Phone:830-773-4288
Mailing Address - Fax:830-773-8539
Practice Address - Street 1:341 CEYLON ST
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852
Practice Address - Country:US
Practice Address - Phone:830-773-4288
Practice Address - Fax:830-773-8539
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1450207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114433901Medicaid
D97696Medicare UPIN
TX114433901Medicaid