Provider Demographics
NPI:1578656658
Name:HUNT, LYN I (MD)
Entity Type:Individual
Prefix:
First Name:LYN
Middle Name:I
Last Name:HUNT
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:PO BOX 99371
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0371
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-7347
Practice Address - Street 1:1500 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2710
Practice Address - Country:US
Practice Address - Phone:682-885-1990
Practice Address - Fax:682-885-1985
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE61062080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U87ZOtherBCBSTX GRP PIN
TX140442852Medicaid
TX115652100OtherFIRSTCARE PIN
TX127601OtherUHC PIN
TX4611691OtherCIGNA PIN
TX130221807Medicaid
TX1416741OtherFIRSTHEALTH PIN
TX133207OtherPHCS PIN
TX130221811OtherCSHCN
TX10028596OtherAMERIGROUP PIN
TX124216OtherSUPERIOR PIN
TX4235049OtherAETNA PIN
TX8G7690OtherBCBSTX IND PIN
1750369203OtherGRP NPI NUMBER
TX8622B9Medicare PIN
TX115652100OtherFIRSTCARE PIN
TX00U87ZOtherBCBSTX GRP PIN