Provider Demographics
NPI:1922272574
Name:ROYAL SUNTOMED MEDICAL GROUP
Entity Type:Organization
Organization Name:ROYAL SUNTOMED MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMEED
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOSUNMU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACP
Authorized Official - Phone:210-593-0390
Mailing Address - Street 1:3330 SABLE CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2219
Mailing Address - Country:US
Mailing Address - Phone:210-912-8652
Mailing Address - Fax:
Practice Address - Street 1:7434 LOUIS PASTEUR DR
Practice Address - Street 2:SUITE 309
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4538
Practice Address - Country:US
Practice Address - Phone:210-593-0390
Practice Address - Fax:210-593-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3285207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F20518Medicare PIN