MEDICARE: SUNIL KURUP 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	207Q00000X	Family Medicine Physician	42903	AZ
2	207Q00000X	Family Medicine Physician	0101246205	VA
3	207QS0010X	Sports Medicine (Family Medicine) Physician	Q6440	TX

General Provider Information

NPI Number	:	1952532988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNIL KURUP M.D.

Provider Business Mailing Address
First Line	:	2821 ROUTH ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-1414
Country	:	US
Telephone Number	:	214-296-0269
Fax Number	:	469-212-1188

Provider Business Practice Location Address
First Line	:	2821 ROUTH ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-1414
Country	:	US
Telephone Number	:	214-296-0269
Fax Number	:	469-212-1188

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

Provider Enumeration Date	:	08/08/2009
Last Update Date	:	02/18/2020

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Directions to “ SUNIL KURUP M.D.” Practice Location

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