Provider Demographics
NPI:1457431413
Name:PRASHANTH R. SUNKUREDDI, M.D., P.A.
Entity Type:Organization
Organization Name:PRASHANTH R. SUNKUREDDI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-957-9127
Mailing Address - Street 1:3725 E LEAGUE CITY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7374
Mailing Address - Country:US
Mailing Address - Phone:281-957-9127
Mailing Address - Fax:281-957-9157
Practice Address - Street 1:3725 E LEAGUE CITY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7374
Practice Address - Country:US
Practice Address - Phone:281-957-9127
Practice Address - Fax:281-957-9157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1374207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0094QHOtherBC/BS
TXDG9219OtherRAILROAD MEDICARE
TX0094QHOtherBC/BS
TXI64974Medicare UPIN