Provider Demographics
NPI:1619045937
Name:PARK, HUI JUN (DC PC)
Entity Type:Individual
Prefix:MR
First Name:HUI
Middle Name:JUN
Last Name:PARK
Suffix:
Gender:M
Credentials:DC PC
Other - Prefix:MR
Other - First Name:HUI
Other - Middle Name:JUN
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:11703 EASTEX FWY STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-6213
Mailing Address - Country:US
Mailing Address - Phone:832-683-4132
Mailing Address - Fax:832-683-4133
Practice Address - Street 1:11703 EASTEX FWY STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-6213
Practice Address - Country:US
Practice Address - Phone:281-590-1000
Practice Address - Fax:281-590-3475
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126718363LF0000X
TX792392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP126718OtherFNP
TXAP126718OtherFNP
TX018456601Medicaid
TXDC8585TXOtherCHIRO BOARD OF TX