Provider Demographics
NPI:1790120053
Name:PARK, CHRISTINE JOOHEE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:JOOHEE
Last Name:PARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 WARREN PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4093
Mailing Address - Country:US
Mailing Address - Phone:972-822-5734
Mailing Address - Fax:
Practice Address - Street 1:5575 WARREN PKWY STE 120
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4093
Practice Address - Country:US
Practice Address - Phone:469-252-0109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM-23812084P0800X
TXV28062084P0800X
CAA1338392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry