MEDICARE: CHUNG SHIN SUNG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	E5952	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2322402	OTHER		BC/BS

General Provider Information

NPI Number	:	1235127002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHUNG SHIN SUNG MD

Provider Business Mailing Address
First Line	:	6624 FANNIN ST
Second Line	:	STE 2320
City	:	HOUSTON
State	:	TX
Zip	:	77030-2312
Country	:	US
Telephone Number	:	713-797-1111
Fax Number	:	713-790-0008

Provider Business Practice Location Address
First Line	:	6624 FANNIN ST
Second Line	:	STE 2320
City	:	HOUSTON
State	:	TX
Zip	:	77030-2312
Country	:	US
Telephone Number	:	713-797-1111
Fax Number	:	713-790-0008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	03/28/2013

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Directions to “ CHUNG SHIN SUNG MD” Practice Location

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