Individual
PHILLIP HYUNSUK CHAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 ROSALIND REDFERN GROVER PKWY STE 100, CRADDICK MEDICAL OFFICE BLDG., MIDLAND, TX 79701-5849
(432) 687-1949
(432) 687-4251
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q8851
TX
207RH0003X
Hematology & Oncology Physician
Primary
Q8851
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360214601
—
TX
01
—
P01830998
RAILROAD
TX
Enumeration date
06/02/2010
Last updated
10/23/2017
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