Individual
LEI SUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6431 FANNIN STREET, MSB 2.136, HOUSTON, TX 77030-1501
(713) 500-5301
(713) 500-0695
Mailing address
6431 FANNIN STREET, MSB 2.136, HOUSTON, TX 77030-1501
(713) 500-5301
(713) 500-0695
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
D94287
MD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
U6353
TX
Other
Enumeration date
05/25/2017
Last updated
09/11/2023
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