Provider Demographics
NPI:1265669881
Name:PURYEAR, ANGEL SUN (MD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:SUN
Last Name:PURYEAR
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 1:7435 HIGHWAY 6 STE B
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4698
Mailing Address - Country:US
Mailing Address - Phone:832-342-9700
Mailing Address - Fax:
Practice Address - Street 1:7435 HIGHWAY 6 STE B
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4698
Practice Address - Country:US
Practice Address - Phone:832-342-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5878207N00000X
TXBP1-0034032390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program