Provider Demographics
NPI:1306803283
Name:SUN, TOM HONG-CHIH (MD)
Entity type:Individual
Prefix:
First Name:TOM
Middle Name:HONG-CHIH
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2855 GRAMERCY ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1697
Mailing Address - Country:US
Mailing Address - Phone:713-668-6828
Mailing Address - Fax:
Practice Address - Street 1:455 SCHOOL ST
Practice Address - Street 2:47
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4595
Practice Address - Country:US
Practice Address - Phone:281-351-7483
Practice Address - Fax:281-351-9771
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6258207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113484306Medicaid
TX8F1140OtherBLUE CROSS & BLUE SHIELD
TX113484305Medicaid