Sundance Behavioral Health Care, Inc

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

SUNDANCE BEHAVIORAL HEALTH CARE, INC

Doing business as

Sundance Behavioral Healthcare

Practice address

2707 Airport Fwy
Fort Worth, TX 76111-2370

Phone

(817) 222-9191

Fax

(817) 222-9797

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

Padmanabha Raju Indukuri

Title

Owner

Phone

(817) 222-9191

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sundance Behavioral Healthcare Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashoo M Rao, MD

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1861580623
  NPD
• Miriam Espinoza, DNP, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Yuma, AZ
  • NPI 1073915633
  NPD
• Roci Rochelle Ruffin, LPC

  • Professional Counselor
  • Fort Worth, TX
  • NPI 1346665395
  NPD (past)
• Kishore Sunkara, M.D.

  • Child & Adolescent Psychiatry Physician
  • Fort Worth, TX
  • NPI 1801841762
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1235157165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 HIGHWAY 287",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760012805",
            "telephone_number": "817-583-8080",
            "fax_number": "817-483-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 AIRPORT FWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761112370",
            "telephone_number": "817-222-9191",
            "fax_number": "817-222-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE BEHAVIORAL HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "INDUKURI",
        "authorized_official_first_name": "PADMANABHA",
        "authorized_official_middle_name": "RAJU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-222-9191"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17889802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "TXB135639",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sundance Behavioral Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Sun
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• Sundance Apothecary, LP
• Sundance Apothecary, LP (ReNue RX #4)
• Sundance Physical Medicine PLLC
• Sundance Speech Therapy, PLLC
• Gloria Sung, PHARM.D.
• Kishore Sunkara, M.D.
• Sunny Side of the Street Pediatric Dentistry

• Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.