Organization Active NPI

Sundaram Sukumar MD PA

  • Internal Medicine Physician
  • Killeen, TX
National Provider Identifier
1588645022
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J3239 Issued in TX
Legal business name
SUNDARAM SUKUMAR MD PA
Practice address
2301 S Clear Creek Rd
#112
Killeen, TX 76549-4143
Phone
(254) 519-3131
Fax
(254) 519-3133
NPI assigned
Nov 10, 2005
Last updated
Jan 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Authorized official

Name
Mr. Sundaram Sukumar, MDNPI 1336120880
Title
MD Owner
Phone
(254) 519-3131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J3239 TX Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X J3626 TX

Addresses

Primary practice location

2301 S Clear Creek Rd
#112
Killeen, TX 76549-4143

Mailing address

2301 S Clear Creek Rd
#112
Killeen, TX 76549-4143
Phone (254) 519-3131

Other identifiers 1

IdentifierTypeStateIssuer
149340501MedicaidTX

National Provider Directory

National Provider Directory

Locations

806 E Avenue D
Ste H
Copperas Cove, TX 76522
Phone (254) 518-5511

2301 Clear Creek Rd
Ste 112
Killeen, TX 76549
Phone (254) 519-3131

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264636800000",
    "number": "1588645022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S CLEAR CREEK RD",
            "address_2": "#112",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494143",
            "telephone_number": "254-519-3131",
            "fax_number": "254-519-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S CLEAR CREEK RD",
            "address_2": "#112",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494143",
            "telephone_number": "254-519-3131",
            "fax_number": "254-519-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDARAM SUKUMAR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-01-28",
        "status": "A",
        "authorized_official_last_name": "SUKUMAR",
        "authorized_official_first_name": "SUNDARAM",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "254-519-3131",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J3239",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "J3626",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149340501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; 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.