Individual
DR. KI EUN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5200 HARRY HINES BLVD, DALLAS, TX 75235-7709
(214) 590-8000
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
(352) 262-9022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
TRN10058
FL
207RC0000X
Cardiovascular Disease Physician
ME104561
FL
207RI0011X
Interventional Cardiology Physician
Primary
V0095
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012805200
—
FL
Enumeration date
10/10/2006
Last updated
06/05/2024
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