Provider Demographics
NPI:1477588069
Name:KUMAR, ANSUYA S (MD)
Entity Type:Individual
Prefix:
First Name:ANSUYA
Middle Name:S
Last Name:KUMAR
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 1:4132 WIND DANCE CIR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7089
Mailing Address - Country:US
Mailing Address - Phone:972-712-5948
Mailing Address - Fax:
Practice Address - Street 1:4132 WIND DANCE CIR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7089
Practice Address - Country:US
Practice Address - Phone:972-712-5948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2521207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB0104946OtherDPS
TX0-417-859-6OtherECFMG
TXK2521OtherMEDICAL LICENSE
TXK2521OtherMEDICAL LICENSE
TXG46907Medicare UPIN
TX287316Medicare PIN
TXBK5293927OtherDEA
TXB0104946OtherDPS
TXG46907Medicare UPIN