Suraphandhu Srivathanakul, M.D

Primary specialty

SpecialistTaxonomy code 174400000X

License

E7288 Issued in TX

Practice address

2630 N Fitzhugh Ave
Dallas, TX 75204-3366

Phone

(214) 826-6420

Fax

(214) 826-6739

NPI assigned

Apr 27, 2007

Last updated

Mar 30, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1912127127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 N FITZHUGH AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752043366",
            "telephone_number": "214-826-6420",
            "fax_number": "214-826-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 N FITZHUGH AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752043366",
            "telephone_number": "214-826-6420",
            "fax_number": "214-826-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVATHANAKUL",
        "first_name": "SURAPHANDHU",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "E7288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1202772-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pallavi Srivastava, MBBS
• Shweta Srivastava, MD
• Sonali Srivastava
• Udayan Srivastava, MD
• Sunti S. Srivathanakul, MD
• Amulya Srivatsa, MD
• Praveen Ranga Srungaram, MD
• SSC North Dallas Operating Company (North Dallas Rehabilitation Hospital)
• Jennifer Nassanga Ssedyabane, AGACNP-BC
• SSK Associates Inc. (Dependable Hospice Care)

• Specialist in Dallas, TX
• Providers in Dallas, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.