Basic Information
| Provider Information | |||||||||
| NPI: | 1578656658 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUNT | ||||||||
| FirstName: | LYN | ||||||||
| MiddleName: | I | ||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 99371 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761990371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6828851855 | ||||||||
| FaxNumber: | 6828857347 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 COOPER ST | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761042710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6828851990 | ||||||||
| FaxNumber: | 6828851985 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 04/04/2012 | ||||||||
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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 | 2080P0206X | E6106 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 00U87Z | 01 | TX | BCBSTX GRP PIN | OTHER | 140442852 | 05 | TX | MEDICAID | 115652100 | 01 | TX | FIRSTCARE PIN | OTHER | 127601 | 01 | TX | UHC PIN | OTHER | 4611691 | 01 | TX | CIGNA PIN | OTHER | 130221807 | 05 | TX | MEDICAID | 1416741 | 01 | TX | FIRSTHEALTH PIN | OTHER | 133207 | 01 | TX | PHCS PIN | OTHER | 130221811 | 01 | TX | CSHCN | OTHER | 10028596 | 01 | TX | AMERIGROUP PIN | OTHER | 124216 | 01 | TX | SUPERIOR PIN | OTHER | 4235049 | 01 | TX | AETNA PIN | OTHER | 8G7690 | 01 | TX | BCBSTX IND PIN | OTHER | 1750369203 | 01 | GRP NPI NUMBER | OTHER |