Provider Demographics
NPI:1639599939
Name:CHOE, CALEB SUNG
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:SUNG
Last Name:CHOE
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 1:2209 MARVEL DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-5027
Mailing Address - Country:US
Mailing Address - Phone:469-371-0033
Mailing Address - Fax:
Practice Address - Street 1:920 MEDICAL PLAZA DR STE 530
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3259
Practice Address - Country:US
Practice Address - Phone:832-562-2009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0208208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics