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NPI Code Detail

MEDICARE: SUN MEDICAL TECHNOLOGIES, INC.

MEDICARE: SUN MEDICAL TECHNOLOGIES, INC.
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
1208800000XUrology Physician
2261QL0400XLithotripsy Clinic/Center

General Provider Information

NPI Number : 1447349360
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUN MEDICAL TECHNOLOGIES, INC.
Provider Business Mailing Address
First Line : 1990 STEAM WAY STE A102
Second Line :
City : ROUND ROCK
State : TX
Zip : 78665-2233
Country : US
Telephone Number : 877-465-4845
Fax Number : 512-872-5105
Provider Business Practice Location Address
First Line : 1990 STEAM WAY STE A102
Second Line :
City : ROUND ROCK
State : TX
Zip : 78665-2233
Country : US
Telephone Number : 877-465-4845
Fax Number : 512-872-5105
Authorized Official
Title or Position : PAYER RELATIONS
Name : MRS. LATANYA CASTILE
Credential :
Telephone Number : 877-465-4845
Provider Enumeration Date : 10/11/2006
Last Update Date : 05/20/2024

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