Provider Demographics
NPI:1205870821
Name:BURMAN, SUDEEP (MD)
Entity type:Individual
Prefix:DR
First Name:SUDEEP
Middle Name:
Last Name:BURMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SUDEEP
Other - Middle Name:
Other - Last Name:BURMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8440 WALNUT HILL LN
Mailing Address - Street 2:SUITE 510
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3833
Mailing Address - Country:US
Mailing Address - Phone:214-345-4406
Mailing Address - Fax:214-345-5543
Practice Address - Street 1:8440 WALNUT HILL LN
Practice Address - Street 2:SUITE 510
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3833
Practice Address - Country:US
Practice Address - Phone:214-345-4406
Practice Address - Fax:214-345-5543
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0667174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103370601Medicaid
TX083687601Medicaid
TX82R844Medicare PIN
TX083687601Medicaid
TX103370601Medicaid