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 1:6410 FANNIN ST STE 500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6431 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-486-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0055243207PP0204X
NJ25MA08645000208000000X, 2080S0010X
TXR60182080S0010X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine