SUMMIT GASTROENTEROLOGY PLLC
Osteopathic Medicine at Broad St, Midlothian, TX

License number
Texas P1484
Category
Osteopathic Medicine
Type
Gastroenterology
Owner
Name: SUNITHA PUDHOTA MD
Title: OWNER
Phone: (972) 314-9900
Address
Address 2
1770 E Broad St STE 102, Midlothian, TX 76063
PO Box 630796, Irving, TX 75063
National Provider ID: 1114355385
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SUMMIT GASTROENTEROLOGY, PLLC

9518 Vly Rnch Pkwy W, Irving, TX 75063

Industry:
Nonclassifiable Establishments
Doing business as:
Summit Gastroenterology, Pllc
Registration:
Sep 25, 2013
State ID:
0801856245
Business type:
Domestic Limited Liability Company (LLC)
Managing Members:
Sunitha Pudhota (PRESIDENT, President), 9518 Vly Rnch Pkwy W, Irving, TX 75063,Sai Md Pllc Managing Member, inactive,Pllc Sai Managing Member, inactive
Agent:
Sunitha G Pudhota,9518 Vly Rnch Pkwy W, Irving, TX 75063 (Physical)
TIN:
32052068031

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