Individual
SUENG K PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E1917
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129866301
—
TX
05
—
129866306
—
TX
05
—
129866307
—
TX
01
—
8AN893
BCBS
TX
Enumeration date
10/31/2005
Last updated
12/02/2009
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