Provider Demographics
NPI:1023545266
Name:SONG, JUNG HUN
Entity Type:Individual
Prefix:DR
First Name:JUNG
Middle Name:HUN
Last Name:SONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26410 OAK RIDGE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1965
Mailing Address - Country:US
Mailing Address - Phone:281-940-5674
Mailing Address - Fax:
Practice Address - Street 1:26410 OAK RIDGE DR STE 104
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1965
Practice Address - Country:US
Practice Address - Phone:281-940-5674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01768171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist