Provider Demographics
NPI:1568445740
Name:SUNKUREDDI, PRASHANTH R (MD)
Entity Type:Individual
Prefix:DR
First Name:PRASHANTH
Middle Name:R
Last Name:SUNKUREDDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3725 E LEAGUE CITY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7374
Mailing Address - Country:US
Mailing Address - Phone:281-957-9127
Mailing Address - Fax:281-957-9157
Practice Address - Street 1:3725 E LEAGUE CITY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7374
Practice Address - Country:US
Practice Address - Phone:281-957-9127
Practice Address - Fax:281-957-9157
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1374207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00462677OtherRAILROAD MEDICARE
TX8AR710OtherBC/BS
TXI64974Medicare UPIN
TX8F3939Medicare PIN