Arvind Manisundaram

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

U9593 Issued in TX

Practice address

415 E Southlake Blvd Ste 101
Southlake, TX 76092-6279

Phone

(817) 416-8080

Fax

(817) 421-8327

NPI assigned

Apr 14, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1801282132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E SOUTHLAKE BLVD STE 101",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926279",
            "telephone_number": "817-416-8080",
            "fax_number": "817-421-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E SOUTHLAKE BLVD STE 101",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926279",
            "telephone_number": "817-416-8080",
            "fax_number": "817-421-8327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Bridgeview Cir",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391578601",
            "country_code": "US",
            "telephone_number": "601-506-7113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANISUNDARAM",
        "first_name": "ARVIND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "U9593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Mallek
• Brady Mallory, D.P.M.
• Delaney Malloy
• John Gregg Malone, LPC-S
• Sylvia Manandhar
• Michelle Marie Mann, RBT
• Amber Mansaray
• Paul Thomas Marciano, DPM
• David P Margraf, MD
• Jeffrey A Marler, PHD CCC-SLP

• Plastic and Reconstructive Surgery Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.