MEDICARE: DR. KISHORE SUNKARA M.D.

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	2084P0800X	Psychiatry Physician	H7837	TX
2	2084P0804X	Child & Adolescent Psychiatry Physician	H7837	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801841762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KISHORE SUNKARA M.D.

Provider Business Mailing Address
First Line	:	2707 AIRPORT FWY
Second Line	:	SUITE:216
City	:	FORT WORTH
State	:	TX
Zip	:	76111-2370
Country	:	US
Telephone Number	:	817-763-5665
Fax Number	:	817-763-5695

Provider Business Practice Location Address
First Line	:	2707 AIRPORT FWY
Second Line	:	SUITE:216
City	:	FORT WORTH
State	:	TX
Zip	:	76111-2370
Country	:	US
Telephone Number	:	817-763-5665
Fax Number	:	817-763-5695

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	08/01/2008

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