Provider Demographics
NPI:1568404614
Name:GUNN, ANGELYN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELYN
Middle Name:
Last Name:GUNN
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 1:20320 NORTHWEST FWY
Mailing Address - Street 2:SUITE 900
Mailing Address - City:JERSEY VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5641
Mailing Address - Country:US
Mailing Address - Phone:281-453-7232
Mailing Address - Fax:281-440-2020
Practice Address - Street 1:16750 RED OAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2543
Practice Address - Country:US
Practice Address - Phone:281-453-7110
Practice Address - Fax:281-440-2020
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL29132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1475675-06Medicaid
TXP00355388OtherMEDICARE RAILROAD
TX8G5840Medicare PIN