Provider Demographics
NPI:1699972364
Name:KUMAR, KARTIK SAMPATH (MD)
Entity type:Individual
Prefix:DR
First Name:KARTIK
Middle Name:SAMPATH
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3200 N MACARHUR BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-1521
Mailing Address - Country:US
Mailing Address - Phone:972-258-7979
Mailing Address - Fax:972-570-5502
Practice Address - Street 1:3200 N MACARHUR BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-1521
Practice Address - Country:US
Practice Address - Phone:972-258-7979
Practice Address - Fax:972-570-5502
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP4972207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX316722301Medicaid
TX316722302OtherCSHCN
TX277705YQQ8Medicare PIN