Provider Demographics
NPI:1851395438
Name:SUNDER, LALITHA L (MD)
Entity Type:Individual
Prefix:DR
First Name:LALITHA
Middle Name:L
Last Name:SUNDER
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 1:915 GESSNER
Mailing Address - Street 2:STE 925
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2402
Mailing Address - Country:US
Mailing Address - Phone:713-973-8821
Mailing Address - Fax:713-973-8492
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:STE 925
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-973-8821
Practice Address - Fax:713-973-8492
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2007-10-17
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
TXJ8388207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AJ314OtherBCBSTX
TX8A6411Medicare PIN