Individual provider Active NPI

Sundeep S Lal, MD

  • Pain Medicine Physician
  • Victoria, TX
National Provider Identifier
1104818095
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
N9382 Issued in TX
Practice address
2705 Hospital Dr
Ste 206
Victoria, TX 77901-5775
Phone
(361) 582-7989
Fax
(361) 582-7990
NPI assigned
Aug 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X E3708 AR
Pain Medicine Physician 208VP0000X N9382 TX Primary

Addresses

Primary practice location

2705 Hospital Dr
Ste 206
Victoria, TX 77901-5775

Mailing address

2705 Hospital Dr
Ste 206
Victoria, TX 77901-5775
Phone (361) 582-7989

Other identifiers 1

IdentifierTypeStateIssuer
150135001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000663 TX Practitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 5991708406 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E3708ARMDOrthopaedic Surgery Physician
N9382TXMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sundeep Lal PA Pain Medicine CurrentSince Mar 5, 2013 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Ozarks Medical Center Pain Medicine Past Accepting new patients
Orthoarkansas, P.a. Orthopaedic Surgery Past Accepting new patients

Locations

2705 Hospital Dr
Ste 206
Victoria, TX 77901
Phone (361) 574-1899

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1104818095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 HOSPITAL DR",
            "address_2": "STE 206",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015775",
            "telephone_number": "361-582-7989",
            "fax_number": "361-582-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 HOSPITAL DR",
            "address_2": "STE 206",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015775",
            "telephone_number": "361-582-7989",
            "fax_number": "361-582-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAL",
        "first_name": "SUNDEEP",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AR",
            "license": "E3708",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "N9382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150135001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.