Provider Demographics
NPI:1457886939
Name:CHOI, SUNG (LAC)
Entity Type:Individual
Prefix:
First Name:SUNG
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 HARRY WURZBACH RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-5015
Mailing Address - Country:US
Mailing Address - Phone:210-722-2334
Mailing Address - Fax:
Practice Address - Street 1:2421 HARRY WURZBACH RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5015
Practice Address - Country:US
Practice Address - Phone:210-722-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005892-1171100000X
TXAC01918171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist