Individual
JASON YOUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-1620
(214) 648-4080
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 648-1620
(214) 648-4080
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
D66835
MD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MT181938
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
N6561
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418096800
—
MD
Enumeration date
01/02/2007
Last updated
02/11/2011
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