Individual
SO MYUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 UNIVERSITY OF NEW MEXICO MSC10 5550, ALBUQUERQUE, NM 87131-0001
(505) 272-6331
(505) 272-0475
Mailing address
2705 BURGUNDY TRL, ROWLETT, TX 75088-6727
(214) 830-9023
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2021
Last updated
04/15/2021
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