Moon, Song Jun

Moon, Song Jun is an sole proprietor health care provider with primary practice located at 1100 Wilford Hall Loop Bldg 4554 , Lackland Afb TX 78236-5638. He recently has only one registered license in Other Service Providers / Military Health Care Provider, which is considered as his primary health care specialty. Moon, Song Jun can be contacted via phone (210) 292-1455.

Contact Information

Primary practice address
1100 Wilford Hall Loop Bldg 4554 Lackland Afb TX 78236-5638
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Military Health Care Provider 171000000X

Profile Details

NPI number 1780019539
LBN Legal business name Moon, Song Jun
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 12th, 2013
Last updated Nov 6th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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