Basic Information
Provider Information
NPI: 1760624928
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REDDY
FirstName: SUNIL
MiddleName: KUMAR CHILLAKURU
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8440 WALNUT HILL LN STE 700
Address2:  
City: DALLAS
State: TX
PostalCode: 752313824
CountryCode: US
TelephoneNumber: 2143613300
FaxNumber: 2143613431
Practice Location
Address1: 4510 MEDICAL CENTER DR STE 108
Address2:  
City: MCKINNEY
State: TX
PostalCode: 750691624
CountryCode: US
TelephoneNumber: 2143613300
FaxNumber: 2143613431
Other Information
ProviderEnumerationDate: 04/01/2009
LastUpdateDate: 01/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XP9708TXN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0001XP9708TXY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology

No ID Information.


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