1831370758 NPI number — DR. SUNIL RAMESH MAHBUBANI M.D.

Table of content: DR. SUNIL RAMESH MAHBUBANI M.D. (NPI 1831370758)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831370758 NPI number — DR. SUNIL RAMESH MAHBUBANI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAHBUBANI
Provider First Name:
SUNIL
Provider Middle Name:
RAMESH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831370758
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3824 CEDAR SPRINGS RD # 801-1663
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75219-4136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-793-1578
Provider Business Mailing Address Fax Number:
210-587-6564

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5150 LEMMON AVE
Provider Second Line Business Practice Location Address:
STE 108
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75209-6423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-587-6564
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  M9474 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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