Individual
DR. SUMALATHA PATIBANDLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3070 COLLEGE ST, SUITE 301, BEAUMONT, TX 77701-4691
(409) 813-1686
(409) 813-3052
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
L7102
TX
207RX0202X
Medical Oncology Physician
L7102
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159914401
—
TX
05
—
159914402
—
TX
05
—
159914403
—
TX
05
—
514019YZ21
—
TX
01
—
8R1522
BLUE CROSS OF TEXAS
TX
Enumeration date
06/04/2006
Last updated
04/12/2017
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