Provider Demographics
NPI:1528568037
Name:CHO, KYU SANG (RN)
Entity Type:Individual
Prefix:
First Name:KYU
Middle Name:SANG
Last Name:CHO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 GREENVIEW DR # A
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4051
Mailing Address - Country:US
Mailing Address - Phone:254-630-6344
Mailing Address - Fax:
Practice Address - Street 1:2030 GREENVIEW DR # A
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4051
Practice Address - Country:US
Practice Address - Phone:254-630-6344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX812183163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse