Provider Demographics
NPI:1407237829
Name:SUNRISE PEDIATRICS PA
Entity type:Organization
Organization Name:SUNRISE PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AMARNATH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMKUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-679-6165
Mailing Address - Street 1:11920 WESTHEIMER RD
Mailing Address - Street 2:STE. E
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-6676
Mailing Address - Country:US
Mailing Address - Phone:281-679-6165
Mailing Address - Fax:281-858-2369
Practice Address - Street 1:11920 WESTHEIMER RD
Practice Address - Street 2:STE. E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6666
Practice Address - Country:US
Practice Address - Phone:281-679-6165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty