Provider Demographics
NPI:1881653426
Name:LUNDY, DAVID C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:LUNDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:700 OLYMPIC PLAZA CIR
Mailing Address - Street 2:STE 407
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1951
Mailing Address - Country:US
Mailing Address - Phone:903-592-4460
Mailing Address - Fax:903-592-7246
Practice Address - Street 1:700 OLYMPIC PLAZA CIR
Practice Address - Street 2:STE 407
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1951
Practice Address - Country:US
Practice Address - Phone:903-592-4460
Practice Address - Fax:903-592-7246
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE6483207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132642301Medicaid
TX8297B6Medicare ID - Type Unspecified
TXC18617Medicare UPIN