Provider Demographics
NPI:1801841762
Name:SUNKARA, KISHORE (MD)
Entity Type:Individual
Prefix:DR
First Name:KISHORE
Middle Name:
Last Name:SUNKARA
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 1:2707 AIRPORT FWY
Mailing Address - Street 2:SUITE:216
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76111-2370
Mailing Address - Country:US
Mailing Address - Phone:817-763-5665
Mailing Address - Fax:817-763-5695
Practice Address - Street 1:2707 AIRPORT FWY
Practice Address - Street 2:SUITE:216
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-2370
Practice Address - Country:US
Practice Address - Phone:817-763-5665
Practice Address - Fax:817-763-5695
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH78372084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098297702Medicaid
TX098297702Medicaid
TX00F70GMedicare PIN