Healthcare Provider Details

I. General information

NPI: 1902867062
Provider Name (Legal Business Name): HOWARD S NUNN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 CYPRESS PT STE 2050
AMARILLO TX
79124-4910
US

IV. Provider business mailing address

11 CYPRESS PT
AMARILLO TX
79124-4910
US

V. Phone/Fax

Practice location:
  • Phone: 806-683-1153
  • Fax:
Mailing address:
  • Phone: 806-683-1153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberE3386
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberE3386
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: