Provider Demographics
NPI:1609118827
Name:SUNIL, PRAHLAD
Entity Type:Individual
Prefix:
First Name:PRAHLAD
Middle Name:
Last Name:SUNIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18951 N MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4217
Mailing Address - Country:US
Mailing Address - Phone:713-338-5616
Mailing Address - Fax:713-704-3086
Practice Address - Street 1:18951 N MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4217
Practice Address - Country:US
Practice Address - Phone:713-338-5616
Practice Address - Fax:713-704-3086
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127822207R00000X, 208M00000X
TXU2021207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017250100Medicaid
FLM0KQ0OtherBCBS
FLME127822OtherMEDICAL LICENSE
FLIO479ZOtherMEDICARE