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Individual
ROSANNA M. PUN
Active
Individual
ROSANNA M. PUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5787
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y402
MEDICARE PTAN
—
05
—
149833901
—
TX
01
—
8AJ003
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/03/2007
Last updated
04/15/2012
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