Provider Demographics
NPI:1649218736
Name:SR HEALTH CARE PA
Entity Type:Organization
Organization Name:SR HEALTH CARE PA
Other - Org Name:POLK CHILDREN'S CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SINGARAJU
Authorized Official - Middle Name:
Authorized Official - Last Name:KATARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-327-8661
Mailing Address - Street 1:1401 ANDOVER LN
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-2685
Mailing Address - Country:US
Mailing Address - Phone:936-327-8661
Mailing Address - Fax:
Practice Address - Street 1:604 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-3451
Practice Address - Country:US
Practice Address - Phone:936-327-8661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2363208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty