Provider Demographics
NPI:1497763106
Name:SUKUMARAN, ANAKARA (MD)
Entity Type:Individual
Prefix:
First Name:ANAKARA
Middle Name:
Last Name:SUKUMARAN
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 1:6565 FANNIN ST
Mailing Address - Street 2:SUITE B452
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2703
Mailing Address - Country:US
Mailing Address - Phone:713-441-3620
Mailing Address - Fax:
Practice Address - Street 1:6565 FANNIN ST
Practice Address - Street 2:SUITE B452
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-441-3620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8690207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036436604Medicaid
TXP01030518OtherRR MEDICARE
TX036436603Medicaid
TXP00375353OtherRAILROAD MEDICARE
TX036436602Medicaid
TX8V3847OtherBLUE CROSS BLUE SHIELD
TXP01311965OtherRR MEDICARE
TXP01030518OtherRR MEDICARE
TXP01311965OtherRR MEDICARE
TXP01030518OtherRR MEDICARE
NE$$$$$$$$$Medicaid
TXTXB138447Medicare PIN