Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | N7116 | TX |
NPI | 1235285909 |
---|---|
Provider Name | June-Ku Kang |
First Address | Austin, TX 78731-4961 |
Second Address | Austin, TX 78731-4961 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 10/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
212938903 | (05) | TX |