Provider Demographics
NPI:1932147303
Name:SUNEW, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SUNEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 W GRAND PKWY N
Mailing Address - Street 2:STE 130
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-2711
Mailing Address - Country:US
Mailing Address - Phone:281-392-3401
Mailing Address - Fax:281-392-2827
Practice Address - Street 1:1331 W GRAND PKWY N STE 130
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2711
Practice Address - Country:US
Practice Address - Phone:281-392-3401
Practice Address - Fax:281-392-7814
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9414207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005856582Medicaid
VA005856582Medicaid
VA00X466M06Medicare PIN
TX338945YYVBMedicare PIN
DCH35388Medicare UPIN
DC001418M22Medicare PIN