Provider Demographics
NPI:1366618399
Name:MOONAT, SAURABH SURESH (DO)
Entity type:Individual
Prefix:DR
First Name:SAURABH
Middle Name:SURESH
Last Name:MOONAT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17030 NANES DR
Mailing Address - Street 2:STE 211
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2503
Mailing Address - Country:US
Mailing Address - Phone:281-440-5925
Mailing Address - Fax:
Practice Address - Street 1:17030 NANES DR
Practice Address - Street 2:STE 211
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2503
Practice Address - Country:US
Practice Address - Phone:281-440-5925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4596207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine