=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881739209
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VICTOR J. ATUN MD, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2007
-----------------------------------------------------
Last Update Date | 03/07/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17510 W. GRAND PARKWAY S. SUITE 500
-----------------------------------------------------
City | SUGAR LAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77479
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-232-6700
-----------------------------------------------------
Fax | 281-232-4545
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17510 W. GRAND PARKWAY S. SUITE 500
-----------------------------------------------------
City | SUGAR LAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77479
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-232-6700
-----------------------------------------------------
Fax | 281-232-4545
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN/OWNER
-----------------------------------------------------
Name | VICTOR JAIME ATUN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 281-232-6700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | K6747
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | K6986
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2086S0122X
-----------------------------------------------------
Taxonomy Name | Plastic and Reconstructive Surgery Physician
-----------------------------------------------------
License Number | K6986
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------