Provider Demographics
NPI:1922291764
Name:CHUNDURI, ANIL KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:KUMAR
Last Name:CHUNDURI
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 1:633 E FERNHURST DR STE 704
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1587
Mailing Address - Country:US
Mailing Address - Phone:832-437-3856
Mailing Address - Fax:
Practice Address - Street 1:633 E FERNHURST DR STE 704
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1587
Practice Address - Country:US
Practice Address - Phone:832-437-3856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-092042207R00000X, 207RN0300X
TXN8285208M00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2949046Medicaid