Provider Demographics
NPI:1689300626
Name:PAEK, JANGMI
Entity Type:Individual
Prefix:
First Name:JANGMI
Middle Name:
Last Name:PAEK
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 1:7015 ISLE ROYAL LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3566
Mailing Address - Country:US
Mailing Address - Phone:806-787-7898
Mailing Address - Fax:
Practice Address - Street 1:1601 CAMINO LAGO
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3225
Practice Address - Country:US
Practice Address - Phone:972-968-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112824235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist