Individual
PETER YONG SOO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6431 FANNIN ST, MSB 2.116, HOUSTON, TX 77030-1501
(713) 500-7640
(713) 500-7647
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-4997
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
SL1170
NV
2085R0202X
Diagnostic Radiology Physician
Primary
T3676
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2016
Last updated
03/28/2022
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