Provider Demographics
NPI:1770947327
Name:SUHAG, SUNAINA (MD)
Entity type:Individual
Prefix:
First Name:SUNAINA
Middle Name:
Last Name:SUHAG
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 1:6210 E US HWY 290
Mailing Address - Street 2:STE. 420 - CREDENTIALING
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1098
Mailing Address - Country:US
Mailing Address - Phone:512-483-9569
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:11714 WILSON PARKE AVE STE 150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-4061
Practice Address - Country:US
Practice Address - Phone:512-346-6611
Practice Address - Fax:512-406-6267
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS1285208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX400894801Medicaid
TX400894802Medicaid