Provider Demographics
NPI:1689624967
Name:KING, SUMI (MD)
Entity Type:Individual
Prefix:MRS
First Name:SUMI
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BURNSIDE
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-1128
Mailing Address - Country:US
Mailing Address - Phone:194-072-3815
Mailing Address - Fax:940-723-8815
Practice Address - Street 1:6 BURNSIDE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-1128
Practice Address - Country:US
Practice Address - Phone:940-723-8151
Practice Address - Fax:940-723-8815
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9362207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092079501Medicaid
TX825987Medicare ID - Type Unspecified