Provider Demographics
NPI:1548795388
Name:AHN, MIN-SUNG (LAC)
Entity Type:Individual
Prefix:
First Name:MIN-SUNG
Middle Name:
Last Name:AHN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6380 LBJ FWY STE 180
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6435
Mailing Address - Country:US
Mailing Address - Phone:214-909-5722
Mailing Address - Fax:
Practice Address - Street 1:6380 LBJ FWY STE 180
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6435
Practice Address - Country:US
Practice Address - Phone:214-909-5722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00878208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine