Provider Demographics
NPI:1689294605
Name:SZCZECHOWSKI, SEUNGEUN
Entity Type:Individual
Prefix:
First Name:SEUNGEUN
Middle Name:
Last Name:SZCZECHOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8308 PRESTON RD BLDG 200
Mailing Address - Street 2:259
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024
Mailing Address - Country:US
Mailing Address - Phone:940-337-9080
Mailing Address - Fax:
Practice Address - Street 1:8308 PRESTON RD BLDG 200
Practice Address - Street 2:SUITE 259
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024
Practice Address - Country:US
Practice Address - Phone:940-337-9080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000337246ZA2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical