Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | K5368 | TX |
NPI | 1215978051 |
---|---|
Provider Name | Dr. Jonathan Chun Oh |
First Address | Dallas, TX 75391-1230 |
Second Address | Dallas, TX 75246-2003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 26/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
166212403 | (05) | TX |
166212404 | (05) | TX |
166212405 | (05) | TX |
166214401 | (05) | TX |
166214402 | (05) | TX |
200191530A | (05) | OK |
8R1517 | BLUE CROSS OF TEXAS (01) | TX |
I09150 | (02) |