Park, Tae J.

Park, Tae J. is an sole proprietor health care provider with primary practice located at 500 Fort Worth Dr Ste 140 , Denton TX 76201-7527. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Park, Tae J. can be contacted via phone (940) 320-0505.

Contact Information

Primary practice address
500 Fort Worth Dr Ste 140 Denton TX 76201-7527
Phone: (940) 320-0505
Fax: (940) 320-0506
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A90047 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X S1480 Texas

Profile Details

NPI number 1346297660
LBN Legal business name Park, Tae J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 30th, 2006
Last updated Nov 22nd, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1346297660 NPPES
California MEDICAID 00A900470

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