Provider Demographics
NPI:1235215286
Name:SUN, LUCY (MD)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:
Last Name:SUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 W LOVERS LN STE 225
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-4374
Mailing Address - Country:US
Mailing Address - Phone:214-556-8880
Mailing Address - Fax:214-556-8881
Practice Address - Street 1:5600 W LOVERS LN STE 225
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-4374
Practice Address - Country:US
Practice Address - Phone:214-556-8880
Practice Address - Fax:145-568-8812
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242545208600000X, 2086S0129X
TXP62852086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX292521OtherMEDICARE GROUP PTAN
TXTXB155426OtherMEDICARE GROUP PTAN
NY0667910001OtherDME
TXDT4457OtherMEDICARE RAILROAD GROUP PTAN
TXP01223162OtherMEDICARE RAILROAD INDIVIDUAL PTAN
NY02839614Medicaid
NYP00370435OtherMEDICARE RAILROAD
TXTXB156437OtherMEDICARE GROUP PTAN
TX307403YUAVMedicare PIN
TXTXB155426OtherMEDICARE GROUP PTAN
NY0667910001OtherDME
NY02839614Medicaid
TX307403YNV6Medicare PIN