Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | J8037 | TX |
NPI | 1710945886 |
---|---|
Provider Name | Dr. Kevin Lunde |
First Address | Plano, TX 75093-5340 |
Second Address | Plano, TX 75093-5340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 17/06/2011 |