Individual
KWAN JUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6445 MAIN ST STE 2500, HOUSTON, TX 77030
(713) 441-9000
Mailing address
6445 MAIN ST STE 2500, HOUSTON, TX 77030-1502
(713) 441-9000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R6866
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
393153701
—
TX
Enumeration date
04/26/2012
Last updated
02/27/2019
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