Provider Demographics
NPI:1588712848
Name:KALLUMADANDA, SUNAND MONNAIAH (MD)
Entity type:Individual
Prefix:
First Name:SUNAND
Middle Name:MONNAIAH
Last Name:KALLUMADANDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 531968
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78553-1968
Mailing Address - Country:US
Mailing Address - Phone:833-887-4863
Mailing Address - Fax:
Practice Address - Street 1:205 E TORONTO AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1209
Practice Address - Country:US
Practice Address - Phone:956-687-6155
Practice Address - Fax:956-618-0451
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5783207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1935389-03Medicaid
TX193538904Medicaid
TX193538905OtherMEDICAID-CSHCN
TX322039YKSJMedicare UPIN
TX322039ZK0DMedicare PIN