| Suma Gudur Md Pa | |
|
3500 W Wheatland Rd Dallas TX 75237-3460 | |
| (407) 374-3455 | |
| Not Available |
| Full Name | Suma Gudur Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3500 W Wheatland Rd, Dallas, Texas |
| Authorized Official Name and Position | Suma Gudur (PRESIDENT) |
| Authorized Official Contact | 4073743455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suma Gudur Md Pa Po Box 734538 Dallas TX 75373-4538 Ph: (407) 374-3455 | Suma Gudur Md Pa 3500 W Wheatland Rd Dallas TX 75237-3460 Ph: (407) 374-3455 |
| NPI Number | 1710410634 |
|---|---|
| Provider Enumeration Date | 04/07/2017 |
| Last Update Date | 10/27/2023 |
| Medicare PECOS PAC ID | 6608142823 |
|---|---|
| Medicare Enrollment ID | O20171016002325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710410634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | P9361 (Texas) | Primary |
| Provider Name | Suma Gudur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043461585 PECOS PAC ID: 4183763477 Enrollment ID: I20140613000808 |
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