Provider Demographics
NPI:1023286317
Name:SUN, KAI M (DO)
Entity type:Individual
Prefix:DR
First Name:KAI
Middle Name:M
Last Name:SUN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:KAI
Other - Middle Name:JACK
Other - Last Name:SUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:3350 EXECUTIVE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-6878
Mailing Address - Country:US
Mailing Address - Phone:325-245-4501
Mailing Address - Fax:
Practice Address - Street 1:3350 EXECUTIVE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-6878
Practice Address - Country:US
Practice Address - Phone:325-245-4501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9037207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine