Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | D75008 | MD |
N | 2080P0207X | Pediatric Hematology-Oncologist | D75008 | MD |
Y | 2080P0207X | Pediatric Hematology-Oncologist | R6070 | TX |
NPI | 1033378765 |
---|---|
Provider Name | Dr. Sang H Park |
First Address | Houston, TX 77030-2627 |
Second Address | Houston, TX 77030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2008 |
Last Update Date | 14/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
335433400 | (05) | MD |