Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | H8164 | TX |
NPI | 1083838320 |
---|---|
Provider Name | Dr. Sunjun Kang |
First Address | Sunrise, FL 33323 |
Second Address | Lewisville, TX 75057-3629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G83716 | (02) | TX |