Individual provider Active NPI

Vijaya Lakshmi Sudanagunta, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Cedar Hill, TX
National Provider Identifier
1265442602
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
N0484 Issued in TX
Practice address
445 E FM 1382
Suite 3354
Cedar Hill, TX 75104-6047
Phone
(214) 325-1969
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X N0484 TX Primary

Addresses

Primary practice location

445 E FM 1382
Suite 3354
Cedar Hill, TX 75104-6047

Mailing address

445 E FM 1382
Suite 3354
Cedar Hill, TX 75104-6047

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
I20080820000475 TX Practitioner - Geriatric MedicinePractitioner - Family Practice 3678531860

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1265442602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E FM 1382",
            "address_2": "SUITE 3354",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E FM 1382",
            "address_2": "SUITE 3354",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046047",
            "telephone_number": "214-325-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDANAGUNTA",
        "first_name": "VIJAYA",
        "middle_name": "LAKSHMI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "N0484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Hill, TX

Sources for this page

Verify at the official NPI Registry.