Provider Demographics
NPI:1578674305
Name:CHILUKURI, SUNEEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNEEL
Middle Name:
Last Name:CHILUKURI
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 WEST LOOP S
Mailing Address - Street 2:SUITE 800
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3500
Mailing Address - Country:US
Mailing Address - Phone:713-661-4383
Mailing Address - Fax:713-661-4346
Practice Address - Street 1:6565 WEST LOOP S
Practice Address - Street 2:SUITE 800
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3500
Practice Address - Country:US
Practice Address - Phone:713-661-4383
Practice Address - Fax:713-661-4346
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3498207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K4956OtherMEDICARE
TX8K4956OtherMEDICARE
NJH97791Medicare UPIN