Provider Demographics
NPI:1760464093
Name:HUNG, RICHARD T (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:T
Last Name:HUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4191 BELLAIRE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1003
Mailing Address - Country:US
Mailing Address - Phone:713-795-5343
Mailing Address - Fax:713-795-4851
Practice Address - Street 1:4191 BELLAIRE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1003
Practice Address - Country:US
Practice Address - Phone:713-795-5343
Practice Address - Fax:713-795-4851
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5120207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038741702Medicaid
TX8027M0OtherMEDICARE PTAN
TX8Z1237OtherBLUE CROSS
TX040015453Medicare ID - Type UnspecifiedRAILROAD
TX8027M0OtherMEDICARE PTAN