Healthcare Provider Details

I. General information

NPI: 1588712848
Provider Name (Legal Business Name): SUNAND MONNAIAH KALLUMADANDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E TORONTO AVE
MCALLEN TX
78503-1209
US

IV. Provider business mailing address

PO BOX 531968
HARLINGEN TX
78553-1968
US

V. Phone/Fax

Practice location:
  • Phone: 956-687-6155
  • Fax: 956-618-0451
Mailing address:
  • Phone: 833-887-4863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM5783
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: