Alexander P. Sudarshan MD PA

Organization Active NPI Ophthalmology Physician · Brownsville, TX

NPI 1295014389 · NPPES record last updated May 27, 2021

Key facts

NPI
1295014389
Entity type
Organization (NPI type 2)
Primary specialty
Ophthalmology Physician 207W00000X
License
G5668 (TX)
Legal business name
ALEXANDER P. SUDARSHAN MD PA
Practice address
1058 E Los Ebanos Blvd
Brownsville, TX 78520-9988
Phone
(956) 541-4828
Fax
(956) 541-4568
NPI assigned
Aug 8, 2011
Organization subpart
No

Authorized official

Name
Dr. Alexander Pradip Sudarshan, MD
Title
President
Phone
(956) 541-4828

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20111014000325 TX Part B Supplier - Clinic/Group Practice 7113199217 Receives reassigned benefits from 12 practitioners
Practice locations: Brownsville, TX; Weslaco, TX
O20120209000367 TX DME Supplier - Physician - Ophthalmology 7113199217 Practice locations: Brownsville, TX

National Provider Directory

Locations

1058 E Los Ebanos Blvd
Brownsville, TX 78520
Phone (956) 541-4828

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193200000X MULTI-SPECIALTY GROUP
152W00000X 6901TG TX
Optometrist
Group: 193200000X MULTI-SPECIALTY GROUP
152W00000X 3479TG TX
Ophthalmology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207W00000X G5668 TX Yes
Ophthalmology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207W00000X J6751 TX

Addresses

Primary practice location

1058 E Los Ebanos Blvd
Brownsville, TX 78520-9988

Mailing address

1058 E Los Ebanos Blvd
Brownsville, TX 78520-9988
Phone (956) 541-4828

Other identifiers

IdentifierTypeStateIssuer
286292201MedicaidTX

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address alexander.sudarshan.p1@direct.theeyeexperts.nextgenshare.com Direct

Other providers in Brownsville, TX

All providers in Brownsville, TX · Ophthalmology Physician in Texas

Sources for this page

Verify at the official NPI Registry.