Provider Demographics
NPI:1184231383
Name:TORRES, SUNGRYEONG (PA-C)
Entity type:Individual
Prefix:
First Name:SUNGRYEONG
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N AMBURN RD STE 9
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-2466
Mailing Address - Country:US
Mailing Address - Phone:281-218-7200
Mailing Address - Fax:
Practice Address - Street 1:1501 N AMBURN ROAD
Practice Address - Street 2:SUITE 9
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591
Practice Address - Country:US
Practice Address - Phone:281-218-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant