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Organization
SUNDARAM SUKUMAR MD PA
Active
Organization
SUNDARAM SUKUMAR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SUNDARAM SUKUMAR MD (MD OWNER)
(254) 519-3131
Entity
Organization
Contact information
Practice address
2301 S CLEAR CREEK RD, #112, KILLEEN, TX 76549-4143
(254) 519-3131
(254) 519-3133
Mailing address
2301 S CLEAR CREEK RD, #112, KILLEEN, TX 76549-4143
(254) 519-3131
(254) 519-3133
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J3239
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
J3626
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149340501
—
TX
Enumeration date
11/10/2005
Last updated
01/28/2010
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