Meridian Primary Care PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MERIDIAN PRIMARY CARE PLLC

Practice address

5430 Abington Creek LN
Sugar Land, TX 77479-4382

Phone

(510) 463-7717

NPI assigned

May 9, 2019

Last updated

Jul 13, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Subha Rajitha Dommaraju, MD

Title

Owner

Phone

(510) 463-7717

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1184289613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16008",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774966008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 ABINGTON CREEK LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774794382",
            "telephone_number": "510-463-7717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 E Sam Houston Pkwy S",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "TX",
            "postal_code": "775053948",
            "country_code": "US",
            "telephone_number": "713-518-1628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERIDIAN PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "DOMMARAJU",
        "authorized_official_first_name": "SUBHA RAJITHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-463-7717",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.