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NATHAN SUMARSONO
NPI 1063022408
Student in an Organized Health Care Education/Training Program in Dallas, TX

Active since July 31, 2020
5323 HARRY HINES BLVD, DALLAS, TX 75390(214) 648-2168(214) 648-7517 Get Directions Write a Review

NPPES record last updated: July 31, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nathan Sumarsono NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NATHAN SUMARSONO (NPI 1063022408) is an individual student in an organized health care education/training program in Dallas, Texas and active in the NPI registry since July 2020.

NPPES Registry Identity

NPI1063022408
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameNATHAN SUMARSONO
Location Address5323 HARRY HINES BLVDDallas, TX 75390-7201
Mailing Address5323 Harry Hines BlvdDallas, TX 75390-7201 · (214) 648-2168 · Fax (214) 648-7517
Phone(214) 648-2168
Fax(214) 648-7517
Sole ProprietorYes
Enumeration DateJuly 31, 2020
NPPES CertifiedJuly 31, 2020
✔ NPI 1063022408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
5323 HARRY HINES BLVD, Dallas, TX 75390
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. TANYA MARIE PLETIN PA-C
Physician Assistant
5323 HARRY HINES BLVD
DALLAS, TX 75390
Dallas County (214) 648-6400
BENJAMIN SETH MARTINEZ MD
Anesthesiology
5323 HARRY HINES BLVD
DALLAS, TX 75390
Dallas County (214) 648-3111
DR. JYOTHSNA GATTINENI M.D.
Pediatrics
5323 HARRY HINES BLVD
DALLAS, TX 75390
Dallas County (214) 648-3438
LEE M. LUNSFORD MD
Anesthesiology
5323 HARRY HINES BLVD
DALLAS, TX 75390
Dallas County (214) 648-8000
TING-YI CHEN M.D.
Internal Medicine (Infectious Disease)
5323 HARRY HINES BLVD
DALLAS, TX 75390
Dallas County (214) 645-2800
DR. STEPHANIE C JONES MD
Pain Medicine (Interventional Pain Medicine)
5323 HARRY HINES BLVD
DALLAS, TX 75390
Dallas County (214) 648-9374
DR. ALECIA CURLENE NERO M.D.
Internal Medicine (Hematology)
5323 HARRY HINES BLVD
DALLAS, TX 75390
Dallas County (214) 648-4180
DR. KATHERINE ANNA JOHNSON MD
Pediatrics
5323 HARRY HINES BLVD
DALLAS, TX 75390
Dallas County (214) 456-0771

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nathan Sumarsono's NPI number?

The NPI number for Nathan Sumarsono is 1063022408. It was assigned to this individual provider in the NPPES registry on July 31, 2020.

Where is Nathan Sumarsono located?

Nathan Sumarsono practices at 5323 Harry Hines Blvd, Dallas, TX 75390. The listed phone number is (214) 648-2168.

What is Nathan Sumarsono's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Nathan Sumarsono was last updated on July 31, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.