Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | M4438 | TX |
NPI | 1982733762 |
---|---|
Provider Name | Dr. Sushma Penmetsa |
First Address | Houston, TX 77059-3133 |
Second Address | Pasadena, TX 77504-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 08/07/2007 |