Active NPI
Suha Sreeram, M.D.
- Family Medicine Physician
- Bryan, TX
National Provider Identifier
1083650956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- K9672
- Practice address
- 2801 Franciscan Dr
Bryan, TX 77802-2544 - Phone
- (979) 776-3989
- Fax
- (979) 776-5327
- NPI assigned
- Jun 21, 2006
- Last updated
- Jun 26, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | K9672 | TX | Primary |
Addresses
Primary practice location
2801 Franciscan Dr
Bryan, TX 77802-2544
Mailing address
2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-3989
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043759202 | Medicaid | TX | |
| 0052KW | Other | TX | BLUE CROSS NUMBER |
| P00161254 | Other | TX | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K9672 | TX | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214438400000",
"number": "1083650956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 FRANCISCAN DR",
"city": "BRYAN",
"state": "TX",
"postal_code": "778022544",
"telephone_number": "979-776-3989",
"fax_number": "979-776-5327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 FRANCISCAN DR",
"city": "BRYAN",
"state": "TX",
"postal_code": "778022544",
"telephone_number": "979-776-3989",
"fax_number": "979-776-5327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SREERAM",
"first_name": "SUHA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-21",
"last_updated": "2008-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "K9672",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "043759202",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS NUMBER",
"identifier": "0052KW",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00161254",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bryan, TX
- Scott Edward Spencer, M.D.
- Sports Medicine and Regenerative Orthopedics, PLLC
- Sports Medicine and Regenerative Orthopedics, PLLC
- Sports, Back & Pain Mangement Clinic
- Ashley Elisabeth Springer, PA-C
- St Joseph Medical Center
- St Joseph Physician Associates
- St Joseph Physician Associates
- St Joseph Regional Health Center
- St Joseph Regional Health Center (St Joseph Regional Rehabilitation Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.