Provider Demographics
NPI:1881739209
Name:VICTOR J. ATUN MD, PA
Entity type:Organization
Organization Name:VICTOR J. ATUN MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:JAIME
Authorized Official - Last Name:ATUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-232-6700
Mailing Address - Street 1:17510 W. GRAND PARKWAY S.
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-232-6700
Mailing Address - Fax:281-232-4545
Practice Address - Street 1:17510 W. GRAND PARKWAY S.
Practice Address - Street 2:SUITE 500
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-232-6700
Practice Address - Fax:281-232-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6747207W00000X
TXK6986208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029834101Medicaid
TX0069HDOtherBLUE CROSS BLUE SHIELD
TXH26112Medicare UPIN
TX029834101Medicaid