DR. SURESH N PATHIKONDA M.D. NPI 1508804121

NPI Information

NPI: 1508804121
Provider Name: DR. SURESH N PATHIKONDA, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual

CLIA Number: 45D0927529

Address:
601 E AIRLINE RD
VICTORIA, TX
ZIP 77901
Phone: (361) 575-8500
Get Directions

DR. Suresh N Pathikonda, M.D. is a pediatrics in Victoria, TX. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Suresh N Pathikonda, M.D. NPI is 1508804121. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 E AIRLINE RD
VICTORIA, TX
ZIP 77901-926
Phone: (361) 575-8500
Fax: (361) 575-8416

The CLIA number assigned to this NPI record is 45D0927529 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/4/2006 and was last updated on 4/1/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		J8083	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	88071B	OTHER	TEXAS	INDIVIDUAL BCBS
2	742777132	OTHER	TEXAS	TAX ID
3	079684901	MEDICAID	TEXAS
4	127014203	MEDICAID	TEXAS
5	88071B	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	MEDICARE
6	0039AZ	OTHER	TEXAS	GROUP BCBS
7	E32944	MEDICARE UPIN	TEXAS
8	079684902	MEDICAID	TEXAS
9	127014205	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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