Provider Demographics
NPI:1679702690
Name:SEN, SUDIPTA (MD)
Entity type:Individual
Prefix:
First Name:SUDIPTA
Middle Name:
Last Name:SEN
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 1:6431 FANNIN ST
Mailing Address - Street 2:ROOM #5.018
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6202
Mailing Address - Fax:713-500-0648
Practice Address - Street 1:6431 FANNIN ST
Practice Address - Street 2:ROOM #5.018
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-6202
Practice Address - Fax:713-500-0648
Is Sole Proprietor?:No
Enumeration Date:2009-07-12
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206315207L00000X
TXQ4689207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology