Individual
DR. MICHAEL HYUNGWOOK PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2790 LAKE VISTA DR, LEWISVILLE, TX 75067-3884
(972) 459-1300
(972) 459-1382
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
J8708
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129006603
—
TX
05
—
129006604
—
TX
05
—
129006605
—
TX
01
—
8R1520
BLUE CROSS OF TEXAS
TX
Enumeration date
06/12/2006
Last updated
01/20/2020
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