Basic Information
| Provider Information | |||||||||
| NPI: | 1679990527 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LATT | ||||||||
| FirstName: | HTUN | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4411 MEDICAL DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106145400 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4411 MEDICAL DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106145400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2014 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | LL2494 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 17055 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0011X | T5371 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 13994830 | 01 | CAQH | OTHER |