Individual
DR. SANKAR PEMMARAJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6904 PETERS PATH, COLLEYVILLE, TX 76034-6655
(817) 488-9874
(817) 488-2865
Mailing address
6904 PETERS PATH, COLLEYVILLE, TX 76034-6655
(817) 488-9874
(817) 488-2865
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
K8811
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0034KA
BCBS
TX
01
—
8K8791
BCBS
TX
Enumeration date
08/08/2006
Last updated
10/06/2010
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