Kankanala, Suresh

Kankanala, Suresh is an sole proprietor health care provider with primary practice located at 1023 Lipscomb St Ste 200 , Fort Worth TX 76104-3130. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Kankanala, Suresh can be contacted via phone (972) 544-6600.

Contact Information

Primary practice address
1023 Lipscomb St Ste 200 Fort Worth TX 76104-3130
Phone: (972) 544-6600
Fax: (972) 544-6604
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X N5145 Texas
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 57-011410 Ohio

Profile Details

NPI number 1922211697
LBN Legal business name Kankanala, Suresh
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 8th, 2007
Last updated Apr 5th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922211697 NPPES
Texas MEDICAID 214605201

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