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General NPI Number Information
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NPI Number | 1972699627
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Entity Type | Individual
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Provider Name | RUBEN L SUNGA JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 731 12TH AVE NW STE 301
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City | ARDMORE
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State | OK
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Zip | 73401-5761
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Country | US
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Telephone | 580-319-1391
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Fax | 580-319-4004
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Provider Business Mailing Address
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Address Line | 1816 SUNSET PARK TER
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City | ARDMORE
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State | OK
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Zip | 73401-3599
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Country | US
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Telephone | 580-319-1391
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Fax | 580-319-4004
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | K6351
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License Number State | TX
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