Individual provider Active NPI

Soumya Pathuri, MD

  • Pediatrics Physician
  • Katy, TX
National Provider Identifier
1831718188
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
U2973 Issued in TX
Practice address
23900 Katy Fwy
Katy, TX 77494-1323
Phone
(713) 338-6565
NPI assigned
Apr 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10070613 TX
Pediatrics Physician 208000000X U2973 TX Primary

Addresses

Primary practice location

23900 Katy Fwy
Katy, TX 77494-1323

Mailing address

6431 Fannin St
Houston, TX 77030-1501
Phone (713) 338-6565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231014000266 TX Practitioner - Pediatric Medicine 9739534538 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10070613TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Pediatrics CurrentSince Oct 1, 2023 Accepting new patients
Ut Physicians CurrentSince Oct 1, 2023 Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6431 Fannin St
Houston, TX 77030
Phone (713) 500-5800

23900 Katy Fwy
Katy, TX 77494
Phone (281) 644-7000

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1831718188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-338-6565",
            "fax_number": "281-365-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23900 KATY FWY",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941323",
            "telephone_number": "713-338-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHURI",
        "first_name": "SOUMYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10070613",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "U2973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.