Provider Demographics
NPI:1073118444
Name:PANICKER, SUNITHA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SUNITHA
Middle Name:
Last Name:PANICKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 CHOCTAW DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-2301
Mailing Address - Country:US
Mailing Address - Phone:713-715-9648
Mailing Address - Fax:
Practice Address - Street 1:7102 CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1503
Practice Address - Country:US
Practice Address - Phone:972-931-7045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315125976183500000X
TX48378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist