Provider Demographics
NPI:1740623024
Name:WON, CHUNG Y (MD)
Entity type:Individual
Prefix:
First Name:CHUNG
Middle Name:Y
Last Name:WON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:Y
Other - Last Name:WON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:309 MISSION LANE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011
Mailing Address - Country:US
Mailing Address - Phone:832-768-2617
Mailing Address - Fax:
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1608
Practice Address - Country:US
Practice Address - Phone:713-218-2697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR3008207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program