Individual
PETER SUNG JAE BAEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 648-6409
(214) 648-5461
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(469) 291-3369
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M2546
TX
208VP0000X
Pain Medicine Physician
M2546
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179289701
—
TX
05
—
179289702
—
TX
01
—
8S7545
BLUE CROSS
TX
Enumeration date
07/29/2006
Last updated
08/20/2021
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