Provider Demographics
NPI:1104852466
Name:SUN, REGINA LO (M D)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:LO
Last Name:SUN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1535 CULLEN BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-8969
Mailing Address - Country:US
Mailing Address - Phone:713-436-1551
Mailing Address - Fax:713-436-7491
Practice Address - Street 1:1535 CULLEN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-8969
Practice Address - Country:US
Practice Address - Phone:713-436-1551
Practice Address - Fax:713-436-7491
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN48534207W00000X
TXM6905207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190063102Medicaid
TX190063101Medicaid
TX190063103Medicaid
I58224Medicare UPIN
TX190063103Medicaid
TX8F6934Medicare PIN
TX8L22504Medicare PIN
TX190063101Medicaid
TXP00455318Medicare PIN