Provider Demographics
NPI:1083664528
Name:LIN, CHUN M (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUN
Middle Name:M
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5680 FRISCO SQUARE BLVD STE 1200
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3323
Mailing Address - Country:US
Mailing Address - Phone:214-618-3960
Mailing Address - Fax:214-618-8025
Practice Address - Street 1:17051 DALLAS PKWY STE 400
Practice Address - Street 2:SUITE 400
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-7101
Practice Address - Country:US
Practice Address - Phone:214-370-3535
Practice Address - Fax:214-370-0004
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94280208100000X, 2081P2900X
TXM87932081P2900X, 208VP0000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BW307OtherBCBS PIN
TXO00749090OtherRAIL ROAD MEDICARE PIN
TX209274401Medicaid
TX209274401Medicaid