Provider Demographics
NPI:1790079184
Name:PAEK, SO YEON (MD)
Entity type:Individual
Prefix:DR
First Name:SO YEON
Middle Name:
Last Name:PAEK
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 JUNIUS ST STE 420
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1615
Mailing Address - Country:US
Mailing Address - Phone:972-200-7446
Mailing Address - Fax:
Practice Address - Street 1:3900 JUNIUS ST STE 420
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1615
Practice Address - Country:US
Practice Address - Phone:972-200-7446
Practice Address - Fax:972-798-2142
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD15065207N00000X
TXR3729207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology