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Individual

THEODORE CHUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 WILFORD HALL LOOP BLDG 455459, JBSA LACKLAND, TX 78236-5638
(210) 266-5609
Mailing address
WILFORD HALL AMBULATORY SURGICAL CENTER, 1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5315

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101274313
VA
207RC0000X
Cardiovascular Disease Physician
Primary
0101274313
VA

Other

Enumeration date
03/31/2019
Last updated
07/07/2025
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