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General NPI Number Information
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NPI Number | 1265527972
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Entity Type | Organization
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Legal Business Name | SHANKAR SUNDARAM MD PA
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 4510 MEDICAL CENTER DR SUITE 112
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City | MCKINNEY
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State | TX
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Zip | 75069-1650
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Country | US
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Telephone | 972-548-7708
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Fax | 972-542-7401
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Provider Business Mailing Address
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Address Line | 4510 MEDICAL CENTER DR SUITE 112
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City | MCKINNEY
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State | TX
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Zip | 75069-1650
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Country | US
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Telephone | 972-548-7708
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Fax | 972-542-7401
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEBRA PRICE
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Credential |
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Telephone | 972-548-7708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | L6191
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License Number State | TX
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