Provider Demographics
NPI:1235173345
Name:CHERUKU, SUNIL REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:REDDY
Last Name:CHERUKU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 LEANDER RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-8835
Mailing Address - Country:US
Mailing Address - Phone:737-808-4561
Mailing Address - Fax:877-260-0030
Practice Address - Street 1:900 E 30TH ST STE 109
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3323
Practice Address - Country:US
Practice Address - Phone:512-544-5555
Practice Address - Fax:512-544-4143
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4023207R00000X, 2083P0011X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1138000Medicaid
TXG56853Medicare UPIN
TX1138000Medicaid