Provider Demographics
NPI:1730223769
Name:SUN, MEI (AC)
Entity type:Individual
Prefix:
First Name:MEI
Middle Name:
Last Name:SUN
Suffix:
Gender:F
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E. MAIN ST STE #104
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-6060
Mailing Address - Country:US
Mailing Address - Phone:972-234-3168
Mailing Address - Fax:
Practice Address - Street 1:310 E MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-6060
Practice Address - Country:US
Practice Address - Phone:972-234-3168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00457171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0003LQOtherBSBC PROVIDER NUMBER