Healthcare Provider Details

I. General information

NPI: 1144632167
Provider Name (Legal Business Name): SUNIL KONGARA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2014
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 11TH STREET UNIT B
WICHITA FALLS TX
76301-4917
US

IV. Provider business mailing address

1631 11TH STREET UNIT B
WICHITA FALLS TX
76301-4917
US

V. Phone/Fax

Practice location:
  • Phone: 940-263-3000
  • Fax: 940-263-3018
Mailing address:
  • Phone: 940-263-3000
  • Fax: 940-263-3018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01097193A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR2383
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: