Provider Demographics
NPI:1952532988
Name:KURUP, SUNIL (MD)
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:
Last Name:KURUP
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 1:2821 ROUTH ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-1414
Mailing Address - Country:US
Mailing Address - Phone:214-296-0269
Mailing Address - Fax:469-212-1188
Practice Address - Street 1:2821 ROUTH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-1414
Practice Address - Country:US
Practice Address - Phone:214-296-0269
Practice Address - Fax:469-212-1188
Is Sole Proprietor?:No
Enumeration Date:2009-08-08
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42903207Q00000X
VA0101246205207Q00000X
TXQ6440207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine