Healthcare Provider Details

I. General information

NPI: 1831731884
Provider Name (Legal Business Name): CHENGYI SUNG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4704 CASTLEMAN DR
AUSTIN TX
78725-1720
US

IV. Provider business mailing address

4704 CASTLEMAN DR
AUSTIN TX
78725-1720
US

V. Phone/Fax

Practice location:
  • Phone: 737-346-5136
  • Fax:
Mailing address:
  • Phone: 737-346-5136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC01931
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1166512
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number1166512
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: