Basic Information
| Provider Information | |||||||||
| NPI: | 1124053863 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUNG | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16605 SOUTHWEST FWY | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774792345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812750800 | ||||||||
| FaxNumber: | 2812750801 | ||||||||
| Practice Location | |||||||||
| Address1: | 16605 SOUTHWEST FWY | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774793501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812750800 | ||||||||
| FaxNumber: | 2812750801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 11/16/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | K0496 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | K0496 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 044499405 | 05 | TX | MEDICAID | 8W4751 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER |