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Individual
DR. SURESH KANKANALA
Active
Individual
DR. SURESH KANKANALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
N5145
TX
390200000X
Student in an Organized Health Care Education/Training Program
57-011410
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214605201
—
TX
Enumeration date
05/08/2007
Last updated
04/05/2022
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