Provider Demographics
NPI:1396376448
Name:CHOI, WON SEOG
Entity Type:Individual
Prefix:
First Name:WON SEOG
Middle Name:
Last Name:CHOI
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 1:2616 SALADO ST APT 406
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3972
Mailing Address - Country:US
Mailing Address - Phone:765-413-3231
Mailing Address - Fax:
Practice Address - Street 1:2616 SALADO ST APT 406
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3972
Practice Address - Country:US
Practice Address - Phone:765-413-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program