Provider Demographics
NPI:1689770075
Name:PABBISETTY, SWARAJYA LAKSHMI (MD)
Entity Type:Individual
Prefix:
First Name:SWARAJYA
Middle Name:LAKSHMI
Last Name:PABBISETTY
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 1:9105 N WAYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-1030
Mailing Address - Country:US
Mailing Address - Phone:713-633-2020
Mailing Address - Fax:713-636-7193
Practice Address - Street 1:9105 N WAYSIDE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-1030
Practice Address - Country:US
Practice Address - Phone:713-633-2020
Practice Address - Fax:713-636-7193
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187782101Medicaid
TX8X7850OtherBCBS
I69978Medicare UPIN