Healthcare Provider Details

I. General information

NPI: 1932018819
Provider Name (Legal Business Name): SUNSTONE MEDICAL TX PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 MAIN ST
CAMBRIDGE MA
02142-1064
US

IV. Provider business mailing address

245 MAIN ST
CAMBRIDGE MA
02142-1064
US

V. Phone/Fax

Practice location:
  • Phone: 888-413-3711
  • Fax:
Mailing address:
  • Phone: 888-413-3711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CAMERON PEARSON
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 401-477-3172