Provider Demographics
NPI:1437235629
Name:DANDONA, SUKLESH (MD)
Entity Type:Individual
Prefix:
First Name:SUKLESH
Middle Name:
Last Name:DANDONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 MAIN
Mailing Address - Street 2:306
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469
Mailing Address - Country:US
Mailing Address - Phone:281-342-8547
Mailing Address - Fax:281-342-3682
Practice Address - Street 1:1601 MAIN
Practice Address - Street 2:306
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469
Practice Address - Country:US
Practice Address - Phone:281-342-8547
Practice Address - Fax:281-342-3682
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4283207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097465101Medicaid
TX097465101Medicaid
TX00B14TMedicare PIN