Individual
SUKANYA AMBAVARAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2920 N STEMMONS FWY, DALLAS, TX 75247
(214) 630-2331
Mailing address
9719 HICKORY ST, FRISCO, TX 75035-7151
(214) 226-9491
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
N7052
TX
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
N7052
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219946501
—
TX
Enumeration date
04/22/2009
Last updated
02/16/2019
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