Organization
CHARLES R. CHUNG, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES R CHUNG M.D., P.A. (PRESIDENT/PHYSICIAN)
(817) 267-1521
Entity
Organization
Contact information
Practice address
1850 CENTRAL DR. #B, BEDFORD, TX 76021-5890
(817) 267-1521
(817) 267-1523
Mailing address
1850 CENTRAL DR #B, BEDFORD, TX 76021-5890
(817) 267-1521
(817) 267-1523
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
E3149
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111954702
—
TX
Enumeration date
02/19/2010
Last updated
08/03/2010
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