Provider Demographics
NPI:1720591159
Name:CHAUDRY, SUMAIR
Entity Type:Individual
Prefix:
First Name:SUMAIR
Middle Name:
Last Name:CHAUDRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6464 SAN FELIPE ST APT 3202
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2742
Mailing Address - Country:US
Mailing Address - Phone:832-818-5384
Mailing Address - Fax:
Practice Address - Street 1:6464 SAN FELIPE ST APT 3202
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-2742
Practice Address - Country:US
Practice Address - Phone:832-818-5384
Practice Address - Fax:832-818-5384
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135760363L00000X
TXAPRN135760363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner