Basic Information
| Provider Information | |||||||||
| NPI: | 1376861997 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNCITY HOSPITALIST GROUP PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 271949 | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784271949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618842904 | ||||||||
| FaxNumber: | 3618841912 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 ELIZABETH ST | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784042235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618814406 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2010 | ||||||||
| LastUpdateDate: | 01/22/2018 | ||||||||
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| AuthorizedOfficialLastName: | KULKARNI | ||||||||
| AuthorizedOfficialFirstName: | SURESH | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3612447353 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | M1854 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | M1854 | 01 | TX | PERMIT | OTHER |