Individual
MR. SIVARAM SUDHAKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 MEDI PARK, SUITE # 1062, AMARILLO, TX 79106
(806) 463-1652
(806) 463-1736
Mailing address
1901 MEDI PARK, SUITE # 1062, AMARILLO, TX 79106
(806) 463-1652
(806) 463-1736
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
H7836
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130454506
—
TX
01
—
H7836
STATE LICENSE
TX
Enumeration date
10/12/2006
Last updated
11/02/2010
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