Individual
DR. KEVIN SOONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3419 EL SALIDO PKWY STE 100, CEDAR PARK, TX 78613-5639
(512) 918-3937
(512) 918-2028
Mailing address
3022 MILL RUN BND, ROUND ROCK, TX 78665-2776
(412) 913-6819
(512) 918-2028
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9183-TG
TX
152W00000X
Optometrist
OPT003032
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9183-TG
TX OPTOMETRY LICENSE
TX
01
—
OPT003032
GA OPTOMETRY LICENSE
GA
Enumeration date
07/05/2017
Last updated
07/18/2022
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