Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | M6922 | TX |
NPI | 1366620916 |
---|---|
Provider Name | Dr. Celestine Shauching Tung |
First Address | Dallas, TX 75391-1230 |
Second Address | Houston, TX 77054-1934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2008 |
Last Update Date | 04/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202690808 | (05) | TX |
202690809 | (05) | TX |