Provider Demographics
NPI:1871577650
Name:MOONAT, SUNITA (MD)
Entity type:Individual
Prefix:
First Name:SUNITA
Middle Name:
Last Name:MOONAT
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 1:17030 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:281-440-3324
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:281-440-3324
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2747207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035641201Medicaid
B24971Medicare UPIN
TX035641201Medicaid