Healthcare Provider Details

I. General information

NPI: 1992710040
Provider Name (Legal Business Name): SUKANYA BURUGU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUKANYA KAPARTHI

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 SETON CENTER PKWY STE 220
AUSTIN TX
78759-5784
US

IV. Provider business mailing address

6210 E HWY 290
AUSTIN TX
78723-1142
US

V. Phone/Fax

Practice location:
  • Phone: 512-338-8388
  • Fax:
Mailing address:
  • Phone: 512-988-5355
  • Fax: 512-323-0307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL7674
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: