MEDICARE: SUGAR LAND INTERNAL MEDICINE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1184107484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUGAR LAND INTERNAL MEDICINE PLLC

Provider Business Mailing Address
First Line	:	7102 TARRINGTON AVE STE 601
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7281
Country	:	US
Telephone Number	:	346-586-5523
Fax Number	:	281-240-0313

Provider Business Practice Location Address
First Line	:	7102 TARRINGTON AVE STE 601
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7281
Country	:	US
Telephone Number	:	346-586-5523
Fax Number	:	281-213-0169

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	VIJAY KORIMILLI
Credential	:	MD, MPH, HQS
Telephone Number	:	813-928-9255

Provider Enumeration Date	:	09/12/2018
Last Update Date	:	04/13/2026

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