Provider Demographics
NPI:1558892687
Name:KUMAR, KANNAN KARUPPIAH (MBBS)
Entity Type:Individual
Prefix:DR
First Name:KANNAN
Middle Name:KARUPPIAH
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9853 VALLEY RANCH PKWY W
Mailing Address - Street 2:1074 APT
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4679
Mailing Address - Country:US
Mailing Address - Phone:972-214-9597
Mailing Address - Fax:
Practice Address - Street 1:2222 WELBORN ST
Practice Address - Street 2:TEXAS SCOTTISH RITE HOSPITAL
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3924
Practice Address - Country:US
Practice Address - Phone:214-559-7613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10058528207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery