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Individual
MYOUNGSOOK JEONG
Active
Individual
MYOUNGSOOK JEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
788220
TX
363LA2200X
Adult Health Nurse Practitioner
788220
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281971602
—
TX
Enumeration date
09/27/2012
Last updated
02/18/2026
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