Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | E-3076 | TX |
NPI | 1053505966 |
---|---|
Provider Name | Jung J Noh |
First Address | Irving, TX 75061-2222 |
Second Address | Irving, TX 75061-2222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2007 |
Last Update Date | 04/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B25181 | (02) | TX |