Provider Demographics
NPI:1841223542
Name:HAN, MICHELLE MIYEON-HWANG (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MIYEON-HWANG
Last Name:HAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W IH 635 FWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3718
Mailing Address - Country:US
Mailing Address - Phone:972-481-6400
Mailing Address - Fax:972-831-9794
Practice Address - Street 1:400 W IH 635 FWY
Practice Address - Street 2:SUITE 250
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3718
Practice Address - Country:US
Practice Address - Phone:972-481-6400
Practice Address - Fax:972-831-9794
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9882208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN84881FOtherBCBS
TX101229601Medicaid
TN84881FOtherBCBS
TX84881FMedicare PIN