Provider Demographics
NPI:1194933739
Name:SURY, ANU (DO)
Entity type:Individual
Prefix:DR
First Name:ANU
Middle Name:
Last Name:SURY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ANU
Other - Middle Name:
Other - Last Name:SURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:580 S DENTON TAP RD STE 123
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-4099
Mailing Address - Country:US
Mailing Address - Phone:972-462-0762
Mailing Address - Fax:972-393-2133
Practice Address - Street 1:580 S DENTON TAP RD STE 123
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4099
Practice Address - Country:US
Practice Address - Phone:972-462-0762
Practice Address - Fax:972-393-2133
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1487817151OtherGROUP NPI
TX8BL892OtherBCBS
TXDN8858OtherRR MCR GRP PTAN
TXDN8858OtherRR MCR GRP PTAN
TX0TH000Medicare UPIN