Sujana Borra
Individual provider Active NPI Dentist · Alamo, TX
NPI 1801672183 · NPPES record last updated Sep 4, 2023
Key facts
- NPI
- 1801672183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 39971 (TX)
- Practice address
- 1449 W Duranta Ave Ste a
Alamo, TX 78516-2328 - Phone
- (956) 232-9939
- NPI assigned
- Sep 4, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39971 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 39971 | TX | Yes |
Addresses
Primary practice location
1449 W Duranta Ave Ste a
Alamo, TX 78516-2328
Mailing address
14949 San Paulo St
Frisco, TX 75035-5448
Phone (516) 590-5003
Other providers in Alamo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.