Provider Demographics
NPI:1932162146
Name:SUNDARRAJ, SABARI L (MD)
Entity Type:Individual
Prefix:DR
First Name:SABARI
Middle Name:L
Last Name:SUNDARRAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SABARI
Other - Middle Name:LAKSHMI
Other - Last Name:SUNDARRAJ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7105 FM 2920 RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2210
Mailing Address - Country:US
Mailing Address - Phone:281-737-1162
Mailing Address - Fax:281-737-1163
Practice Address - Street 1:7105 FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2210
Practice Address - Country:US
Practice Address - Phone:281-737-1162
Practice Address - Fax:281-737-1163
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA308483207Q00000X
SD10860207Q00000X
MO2018020879207Q00000X
ND15217207Q00000X
OK33524207Q00000X
MA276820207Q00000X
TXM2830207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FT413OtherBLUE CROSS BLUE SHIELD
TX355087ZSWDMedicare PIN
TX8FT413OtherBLUE CROSS BLUE SHIELD