Active NPI
Victor J Atun, MD
- Plastic Surgery Physician
- Sugar Land, TX
National Provider Identifier
1841290095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- K6986
- Practice address
- 17510 W.Grand Parkway S.
Suite 500
Sugar Land, TX 77479-4513 - Phone
- (281) 232-6700
- Fax
- (281) 232-4545
- NPI assigned
- Jul 29, 2005
- Reactivated
- Apr 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | K6986 | TX | Primary |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | K6986 | TX |
Addresses
Primary practice location
17510 W.Grand Parkway S.
Suite 500
Sugar Land, TX 77479-4513
Mailing address
15591 Creek Bend Dr
Ste 100
Sugar Land, TX 77478-4628
Phone (281) 232-6700
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 029834101 | Medicaid | TX | |
| 029834101 | Other | TEXAS CHILDRENS HEALTH PLAN | |
| 2431256 | Other | TX | AETNA US HEALTHCARE |
| 029834101 | Other | TX | AMERIGROUP |
| 8F4931 | Other | TX | BCBS OF TEXAS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542412800000",
"number": "1841290095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15591 CREEK BEND DR",
"address_2": "STE 100",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774784628",
"telephone_number": "281-232-6700",
"fax_number": "281-232-4545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17510 W.GRAND PARKWAY S.",
"address_2": "SUITE 500",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774794513",
"telephone_number": "281-232-6700",
"fax_number": "281-232-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATUN",
"first_name": "VICTOR",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2018-11-17",
"deactivation_date": "2006-03-22",
"reactivation_date": "2006-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": "TX",
"license": "K6986",
"primary": true
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "TX",
"license": "K6986",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "029834101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS CHILDRENS HEALTH PLAN",
"identifier": "029834101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "2431256",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "029834101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "8F4931",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.