Rannulu, Sudath Gunadeera
Rannulu, Sudath Gunadeera is an individual health care provider with primary practice located at 4759 South Fwy Ste 101, Ft Worth TX 76115-3655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Rannulu, Sudath Gunadeera can be contacted via phone (972) 293-6300.Contact Information
Primary practice address
4759 South Fwy Ste 101
Ft Worth TX 76115-3655
Phone: (972) 293-6300
Fax: (972) 293-6301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | P7550 | Texas |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 249270 | New York |
Profile Details
| NPI number | 1932361078 |
|---|---|
| LBN Legal business name | Rannulu, Sudath Gunadeera |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2008 |
| Last updated | Mar 20th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932361078 | NPPES |
| New York | MEDICAID | 02984105 |
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