Provider Demographics
NPI:1174518633
Name:KUMAR, SANJAY (MD)
Entity type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3903 WISEMAN BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4401
Mailing Address - Country:US
Mailing Address - Phone:210-681-0126
Mailing Address - Fax:210-681-5228
Practice Address - Street 1:3011 W LOOP 1604 N STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3901
Practice Address - Country:US
Practice Address - Phone:210-681-0126
Practice Address - Fax:210-681-0138
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2392207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148745601Medicaid
TX148745601Medicaid
TX8522N0Medicare ID - Type Unspecified