Provider Demographics
NPI:1417418682
Name:JEONG, MYOUNGHEE MICHELLE (FNP-BC, NP-C)
Entity Type:Individual
Prefix:MS
First Name:MYOUNGHEE
Middle Name:MICHELLE
Last Name:JEONG
Suffix:
Gender:F
Credentials:FNP-BC, NP-C
Other - Prefix:MS
Other - First Name:MYOUNGHEE
Other - Middle Name:
Other - Last Name:ROH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN STREET JJL 270
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-500-7885
Mailing Address - Fax:713-500-0625
Practice Address - Street 1:11476 SPACE CENTER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-3656
Practice Address - Country:US
Practice Address - Phone:713-486-6325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141080363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care