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General NPI Number Information
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NPI Number | 1801870449
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Entity Type | Individual
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Provider Name | SUNTI S. SRIVATHANAKUL MD
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Gender | Male
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 9202 ELAM RD SOUTHEAST DALLAS HEALTH CENTER
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City | DALLAS
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State | TX
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Zip | 75217-4151
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Country | US
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Telephone | 214-266-1600
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Fax | 214-266-1742
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Provider Business Mailing Address
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Address Line | PO BOX 660599
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City | DALLAS
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State | TX
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Zip | 75266-0599
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J8783
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License Number State | TX
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