Provider Demographics
NPI:1033325030
Name:SUN CITY PULMONARY CRITICAL CARE
Entity Type:Organization
Organization Name:SUN CITY PULMONARY CRITICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PRADYUMNA
Authorized Official - Middle Name:CHARY
Authorized Official - Last Name:MUMMADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FCCP
Authorized Official - Phone:956-568-9400
Mailing Address - Street 1:7210 MCPHERSON RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6505
Mailing Address - Country:US
Mailing Address - Phone:361-452-8360
Mailing Address - Fax:361-452-8359
Practice Address - Street 1:7210 MCPHERSON RD STE 210
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6505
Practice Address - Country:US
Practice Address - Phone:956-568-9400
Practice Address - Fax:956-568-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6171207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148713401Medicaid
TX148713401Medicaid
TXF88704Medicare UPIN