Provider Demographics
NPI:1689257826
Name:SUKUMAR, NIVEDHA ARUMUGAM (DO)
Entity type:Individual
Prefix:DR
First Name:NIVEDHA
Middle Name:ARUMUGAM
Last Name:SUKUMAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:NIVI
Other - Middle Name:
Other - Last Name:SUKUMAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:7601 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3214
Mailing Address - Country:US
Mailing Address - Phone:214-456-9250
Mailing Address - Fax:214-456-1240
Practice Address - Street 1:6431 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:972-672-2824
Practice Address - Fax:713-500-5800
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXV0557208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program