Provider Demographics
NPI:1306846787
Name:PARK, BYUNG RYANG (MD)
Entity Type:Individual
Prefix:
First Name:BYUNG
Middle Name:RYANG
Last Name:PARK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:BYUNG R
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8230 WALNUT HILL LN STE 220
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4425
Mailing Address - Country:US
Mailing Address - Phone:214-345-8692
Mailing Address - Fax:
Practice Address - Street 1:8230 WALNUT HILL LN STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4425
Practice Address - Country:US
Practice Address - Phone:214-345-8692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6211207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110176958OtherRAILROAD MEDICARE LOC 11
TX042813804Medicaid
TX042813803Medicaid
TXP00044325OtherRAILROAD MEDICARE LOC 99
TX042813801Medicaid
TXTXB118495Medicare PIN
TX84010KMedicare PIN
TXP00044325OtherRAILROAD MEDICARE LOC 99
TX042813801Medicaid