Provider Demographics
NPI:1396865499
Name:NARENDIR T SOORYA INC
Entity type:Organization
Organization Name:NARENDIR T SOORYA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NARENDIR
Authorized Official - Middle Name:T
Authorized Official - Last Name:SOORYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-644-2395
Mailing Address - Street 1:6651 CHIPPEWA
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6651 CHIPPEWA
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2538
Practice Address - Country:US
Practice Address - Phone:314-644-2395
Practice Address - Fax:314-644-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty