Provider Demographics
NPI:1962877019
Name:KIRON MEDICAL PLLC
Entity type:Organization
Organization Name:KIRON MEDICAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUN
Authorized Official - Middle Name:B
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-380-2580
Mailing Address - Street 1:PO BOX 2333
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-2333
Mailing Address - Country:US
Mailing Address - Phone:832-380-2580
Mailing Address - Fax:832-380-2583
Practice Address - Street 1:6219 IRVINGTON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-5951
Practice Address - Country:US
Practice Address - Phone:832-380-2580
Practice Address - Fax:832-380-2583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3210207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN3210OtherLICENSE