Provider Demographics
NPI:1700843711
Name:VURIMI, SIVA KUMARI (MD)
Entity Type:Individual
Prefix:
First Name:SIVA
Middle Name:KUMARI
Last Name:VURIMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 S LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7167
Mailing Address - Country:US
Mailing Address - Phone:214-857-3450
Mailing Address - Fax:214-857-3977
Practice Address - Street 1:2737 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1027
Practice Address - Country:US
Practice Address - Phone:214-857-3450
Practice Address - Fax:214-857-3977
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2183207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175440002Medicaid
TX175440001Medicaid
TX8J0093Medicare PIN