Provider Demographics
NPI:1841290145
Name:TSUSAKI, BYRON E (DO)
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:E
Last Name:TSUSAKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4398
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4398
Mailing Address - Country:US
Mailing Address - Phone:832-355-2666
Mailing Address - Fax:832-355-6500
Practice Address - Street 1:6720 BERTNER ST
Practice Address - Street 2:SUITE O-520
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2604
Practice Address - Country:US
Practice Address - Phone:832-355-2666
Practice Address - Fax:832-355-6500
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4595207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036546201Medicaid
TX8G2875Medicare PIN
TXG41133Medicare UPIN
TXDE7892Medicare PIN
TX036546201Medicaid
TXP00317661Medicare PIN