Provider Demographics
NPI:1770624793
Name:HWANG, HOSUN (MD)
Entity type:Individual
Prefix:
First Name:HOSUN
Middle Name:
Last Name:HWANG
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 1:18220 STATE HIGHWAY 249 STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4370
Mailing Address - Country:US
Mailing Address - Phone:281-737-0999
Mailing Address - Fax:281-737-0926
Practice Address - Street 1:18220 STATE HIGHWAY 249 STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4370
Practice Address - Country:US
Practice Address - Phone:281-737-0999
Practice Address - Fax:281-737-0926
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98908207XS0117X
TXM6206207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208172102Medicaid
TX208172104Medicaid
TXP01070528OtherRR MEDICARE
TX1770624793OtherBLUE CROSS BLUE SHIELD
TX610197301 CENTERFIELOtherUS DEPT OF LABOR
616771105OtherUS DEPT OF LABOR
CA00A989080Medicaid
TX208172103Medicaid
601771109OtherUS DEPT OF LABOR
TX610197302 FANNINOtherUS DEPT OF LABOR
616771101OtherUS DEPT OF LABOR
616771110OtherUS DEPT OF LABOR
TX8DY920OtherBLUE CROSS BLUE SHIELD
TXP00998176OtherMEDICARE RR
TXP01258260OtherMEDICARE RR
TXTXB127640Medicare PIN
TX8DY920OtherBLUE CROSS BLUE SHIELD
TXTXB151535Medicare PIN
601771109OtherUS DEPT OF LABOR
616771101OtherUS DEPT OF LABOR
TX8L0059Medicare PIN