1770238461 NPI number — SUNNY NEUROLOGY CLINIC

Table of content: (NPI 1770238461)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770238461 NPI number — SUNNY NEUROLOGY CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUNNY NEUROLOGY CLINIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770238461
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3422 BUSINESS CENTER DR
Provider Second Line Business Mailing Address:
STE 106 #107
Provider Business Mailing Address City Name:
PEARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77584
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-207-6953
Provider Business Mailing Address Fax Number:
281-595-9394

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
710 CYPRESS CREEK PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77090-3402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-207-6953
Provider Business Practice Location Address Fax Number:
281-595-9394
Provider Enumeration Date:
02/21/2022

Additional Information

Authorized Official

Authorized Official Last Name:
SUN
Authorized Official First Name:
LINQUAN
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
410-207-6953

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 448426301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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