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General NPI Number Information
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NPI Number | 1619001534
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Entity Type | Organization
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Legal Business Name | AMY S LUNGREN MD PA
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 04/11/2013
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Provider Practice Location Address
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Address Line | 4370 MEDICAL ARTS DR SUITE 300
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1712
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Country | US
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Telephone | 972-874-5588
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Fax | 972-874-3638
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Provider Business Mailing Address
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Address Line | 4370 MEDICAL ARTS DR SUITE 300
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1712
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Country | US
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Telephone | 972-874-5588
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Fax | 972-874-3638
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMY STOVER LUNGEN
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Credential | M.D.
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Telephone | 972-874-5588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | L7022
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License Number State | TX
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