Provider Demographics
NPI:1831660414
Name:CHOI, SUKJAI A (DC)
Entity Type:Individual
Prefix:
First Name:SUKJAI
Middle Name:A
Last Name:CHOI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 GRAPEVINE HWY STE 400
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2438
Mailing Address - Country:US
Mailing Address - Phone:817-485-2400
Mailing Address - Fax:817-485-2475
Practice Address - Street 1:104 GRAPEVINE HWY STE 400
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2438
Practice Address - Country:US
Practice Address - Phone:817-485-2400
Practice Address - Fax:817-485-2475
Is Sole Proprietor?:No
Enumeration Date:2018-12-08
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13957111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor