Provider Demographics
NPI:1194994616
Name:THOTA, SUJATHA NVENKATA (MD)
Entity type:Individual
Prefix:DR
First Name:SUJATHA
Middle Name:NVENKATA
Last Name:THOTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23423 HIGHWAY 59N
Mailing Address - Street 2:APT#1115
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339
Mailing Address - Country:US
Mailing Address - Phone:281-570-6912
Mailing Address - Fax:
Practice Address - Street 1:23423 HIGHWAY 59 N
Practice Address - Street 2:APT 1115
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1550
Practice Address - Country:US
Practice Address - Phone:231-570-6912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9057207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology