Provider Demographics
NPI:1740224674
Name:JUNG, HARRY H III (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:H
Last Name:JUNG
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 650426
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0426
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:
Practice Address - Street 1:13601 PRESTON RD
Practice Address - Street 2:SUITE 1000W
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4911
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9639207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114735702Medicaid
MI1740224674Medicaid
MI05009011831OtherBCBS
TX114735709Medicaid
TX896865OtherBCBS
TX8BX904OtherBCBS
TX114735711Medicaid
TX8CF244OtherBCBS
NMPENDINGMedicaid
P00720532OtherRAILROAD
TX8AS966OtherBCBS
TX8CI338OtherBCBS
P00771266OtherRAILROAD
TX8CF244OtherBCBS
TX896865Medicare ID - Type Unspecified
TX114735702Medicaid
TX114735711Medicaid
TX114735709Medicaid
TX8L24362Medicare PIN