Pak, James Pyong-Kon

Pak, James Pyong-Kon is an individual health care provider with primary practice located at 815 Pennsylvania Ave , Fort Worth TX 76104-2224. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Pak, James Pyong-Kon can be contacted via phone (817) 321-0387.

Contact Information

Primary practice address
815 Pennsylvania Ave Fort Worth TX 76104-2224
Phone: (817) 321-0387
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X K2256 Texas

Profile Details

NPI number 1831199686
LBN Legal business name Pak, James Pyong-Kon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2005
Last updated Aug 15th, 2012 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1831199686 NPPES
Texas MEDICAID 137723613
Texas MEDICAID 1377236-17
Texas MEDICAID 137723615

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