Provider Demographics
NPI:1134120637
Name:ROYAPPA, SUDHA M (MD)
Entity type:Individual
Prefix:
First Name:SUDHA
Middle Name:M
Last Name:ROYAPPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8210 WALNUT HILL LN
Mailing Address - Street 2:SUITE 306
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4405
Mailing Address - Country:US
Mailing Address - Phone:214-306-4030
Mailing Address - Fax:214-242-6758
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:SUITE 306
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4405
Practice Address - Country:US
Practice Address - Phone:214-306-4030
Practice Address - Fax:214-242-6758
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F9291OtherMEDICARE
TXI21235Medicare UPIN