Provider Demographics
NPI:1457555021
Name:KUNAPULI, SANJAY (MD)
Entity type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:
Last Name:KUNAPULI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18220 TOMBALL PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4347
Mailing Address - Country:US
Mailing Address - Phone:713-441-9909
Mailing Address - Fax:281-737-0968
Practice Address - Street 1:18220 TOMBALL PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:713-441-9909
Practice Address - Fax:281-737-0968
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3805207RI0011X, 207RC0000X
TXBP3-0026823207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01048884OtherRR MEDICARE
TX215084901Medicaid
TX1457555021OtherBLUE CROSS BLUE SHIELD
TXP00919307OtherMEDICARE RR
TX215084902Medicaid
TX8CJ363OtherBCBS
TXP01309422OtherRR MEDICARE
TX215084904Medicaid
TX1457555021OtherBLUE CROSS BLUE SHIELD
TX215084902Medicaid
TXP01309422OtherRR MEDICARE
TXP00919307OtherMEDICARE RR
TX215084901Medicaid