Provider Demographics
NPI:1184762577
Name:SOHN, JEONG-HYEON (MD)
Entity type:Individual
Prefix:
First Name:JEONG-HYEON
Middle Name:
Last Name:SOHN
Suffix:
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 1:8300 FLOYD CURL DR FL 6
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3931
Mailing Address - Country:US
Mailing Address - Phone:210-450-9400
Mailing Address - Fax:210-450-6024
Practice Address - Street 1:8300 FLOYD CURL DR FL 6
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3931
Practice Address - Country:US
Practice Address - Phone:210-450-9400
Practice Address - Fax:210-450-6024
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR0822207W00000X
MDD0066175207W00000X
TXQ4846207W00000X, 207WX0107X
IA38424207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347629301Medicaid
TX419982YK00Medicare PIN