Individual
IVAN YOUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1208 W 38TH ST, AUSTIN, TX 78705-1006
(512) 324-1000
Mailing address
9811 OAK RUN DR, AUSTIN, TX 78758-5545
(512) 598-5840
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP1072471
TX
Other
Enumeration date
02/18/2022
Last updated
03/17/2022
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