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NPI Code Detail

MEDICARE: DR. ANGELYN GUNN MD

MEDICARE: DR. ANGELYN GUNN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianL2913TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00355388OTHERTXMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568404614
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELYN GUNN MD
Provider Business Mailing Address
First Line : 20320 NORTHWEST FWY
Second Line : SUITE 900
City : JERSEY VILLAGE
State : TX
Zip : 77065-5641
Country : US
Telephone Number : 281-453-7232
Fax Number : 281-440-2020
Provider Business Practice Location Address
First Line : 16750 RED OAK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77090-2543
Country : US
Telephone Number : 281-453-7110
Fax Number : 281-440-2020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 10/03/2016

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