Provider Demographics
NPI:1972632917
Name:CHUN, SANG H (MD)
Entity Type:Individual
Prefix:DR
First Name:SANG
Middle Name:H
Last Name:CHUN
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 1:6500 NORTH FWY
Mailing Address - Street 2:#117
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-2941
Mailing Address - Country:US
Mailing Address - Phone:713-691-3313
Mailing Address - Fax:713-691-3337
Practice Address - Street 1:6500 NORTH FWY
Practice Address - Street 2:#117
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-2941
Practice Address - Country:US
Practice Address - Phone:713-691-3313
Practice Address - Fax:713-691-3337
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4098174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC14484Medicare UPIN
TX00TG80Medicare ID - Type Unspecified