Provider Demographics
NPI:1184655938
Name:LUND, STEVEN G (DPM)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:LUND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 CITY POINT DR STE 104
Mailing Address - Street 2:
Mailing Address - City:N RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8380
Mailing Address - Country:US
Mailing Address - Phone:817-595-1310
Mailing Address - Fax:817-595-1321
Practice Address - Street 1:4300 CITY POINT DR STE 104
Practice Address - Street 2:
Practice Address - City:N RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8380
Practice Address - Country:US
Practice Address - Phone:817-595-1310
Practice Address - Fax:817-595-1321
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1697213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0019RLOtherBCBS GROUP ID
TX5416500OtherAETNA
TX166329604Medicaid
TX8BG900OtherBCBS
TX0019RLOtherBCBS GROUP ID
TX5416500OtherAETNA