Healthcare Provider Details

I. General information

NPI: 1699235473
Provider Name (Legal Business Name): ANDREW SHICHEN SUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4316 JAMES CASEY ST. BLDG A, C, E
AUSTIN TX
78745
US

IV. Provider business mailing address

1 BAYLOR PLZ
HOUSTON TX
77030-3411
US

V. Phone/Fax

Practice location:
  • Phone: 512-623-5300
  • Fax: 512-623-5399
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberT6725
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: