Provider Demographics
NPI:1972576502
Name:SWAMY, PONNUSWAMY T (MD)
Entity type:Individual
Prefix:
First Name:PONNUSWAMY
Middle Name:T
Last Name:SWAMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 SARA SWAMY DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090
Mailing Address - Country:US
Mailing Address - Phone:903-893-6311
Mailing Address - Fax:903-870-0456
Practice Address - Street 1:1111 SARA SWAMY DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090
Practice Address - Country:US
Practice Address - Phone:903-893-6311
Practice Address - Fax:903-870-0456
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3475174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist