Suresh B Indupalli MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

LO828 Issued in TX

Legal business name

SURESH B INDUPALLI MD PA

Practice address

4180 Delaware St Ste 102
Beaumont, TX 77706-7859

Phone

(409) 835-4907

Fax

(409) 347-0070

NPI assigned

Feb 18, 2008

Last updated

Oct 11, 2017By 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

Kerrie Thomas

Title

Administrative Assistant

Phone

(409) 835-4907

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Suresh B Indupalli, M.D.

  • Family Medicine Physician
  • Beaumont, TX
  • NPI 1053372359
  Medicare reassignment NPD

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507680000000",
    "number": "1871761338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 DELAWARE ST STE 102",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067859",
            "telephone_number": "409-835-4907",
            "fax_number": "409-347-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 DELAWARE ST STE 102",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067859",
            "telephone_number": "409-835-4907",
            "fax_number": "409-347-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURESH B INDUPALLI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-18",
        "last_updated": "2017-10-11",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "KERRIE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "409-835-4907"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "LO828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeri Boudreaux Sullivan, M.S.
• Kris L Sullivan, DCLS
• Munnaver Sultana, MD
• Kristi Sumrall, MS, CCC-SLP
• Sunny Anesthesia LLP
• Surgical Assist Services
• Surgical Critical Care Associates, LLP
• Surreal Breathing LLC
• Susan K Craig M D P a
• Suzanne Delaney Reuland (Gulf Coast Chiropractic)

• Family Medicine Physician in Beaumont, TX
• Providers in Beaumont, 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 Oct 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.