Provider Demographics
NPI:1376507210
Name:ALEXANDER, SUNITHA CHACKO (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNITHA
Middle Name:CHACKO
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 131594
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77393-1594
Mailing Address - Country:US
Mailing Address - Phone:936-321-6843
Mailing Address - Fax:936-647-1453
Practice Address - Street 1:17350 ST LUKES WAY
Practice Address - Street 2:SUITE 350
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4100
Practice Address - Country:US
Practice Address - Phone:936-321-6843
Practice Address - Fax:936-647-1453
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5467207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX303813501OtherMEDICAID GROUP
TXTXB155358OtherMEDICARE INDIVIDUAL
TX303814301OtherMEDICAID INDIVIDUAL
TXL5467OtherLICENSE
TX20127270OtherDPS
TXTXB155357OtherMEDICARE GROUP
TXTXB155357OtherMEDICARE GROUP
TX303814301OtherMEDICAID INDIVIDUAL
TX303814301OtherMEDICAID INDIVIDUAL