Individual
DR. SRINIVAS SUNKAVALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 W PARK, STE 109, LIVINGSTON, TX 77351
(936) 327-5611
(866) 918-3456
Mailing address
210 W PARK, STE 109, LIVINGSTON, TX 77351
(936) 327-5611
(866) 918-3456
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
M9683
TX
208VP0014X
Interventional Pain Medicine Physician
M9683
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000923202
BLUE CROSS BLUE SHIELD
IL
05
—
036111315
—
IL
Enumeration date
10/12/2006
Last updated
07/17/2018
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