Active NPI
Daniel Edward Supkis Jr., MD
- Anesthesiology Physician
- Houston, TX
National Provider Identifier
1053535484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G3831
- Practice address
- 4704 Montrose Blvd
Houston, TX 77006-6122 - Phone
- (713) 304-5353
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G3831 | TX | Primary |
Addresses
Primary practice location
4704 Montrose Blvd
Houston, TX 77006-6122
Mailing address
303 Timber Terrace Rd
Houston, TX 77024-5602
Phone (713) 304-5353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K0151619 | Other | TX | DPS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1053535484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 TIMBER TERRACE RD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770245602",
"telephone_number": "713-304-5353",
"fax_number": "713-669-1671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4704 MONTROSE BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770066122",
"telephone_number": "713-304-5353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPKIS",
"first_name": "DANIEL",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "G3831",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DPS",
"identifier": "K0151619",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.