Provider Demographics
NPI:1598996993
Name:KUMAR, SURACHIT (MD)
Entity Type:Individual
Prefix:
First Name:SURACHIT
Middle Name:
Last Name:KUMAR
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 1:9900 N CENTRAL EXPY
Mailing Address - Street 2:STE 215
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4395
Mailing Address - Country:US
Mailing Address - Phone:214-396-4950
Mailing Address - Fax:
Practice Address - Street 1:9900 N CENTRAL EXPY
Practice Address - Street 2:STE 215
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4395
Practice Address - Country:US
Practice Address - Phone:214-396-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3394207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology