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NPI Code Detail

MEDICARE: DUCKHYUN JO

MEDICARE: DUCKHYUN JO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2103T00000XPsychologist

General Provider Information

NPI Number : 1275370611
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUCKHYUN JO
Provider Business Mailing Address
First Line : 5200 WESLAYAN ST APT A303
Second Line :
City : HOUSTON
State : TX
Zip : 77005-1204
Country : US
Telephone Number : 323-217-2219
Fax Number :
Provider Business Practice Location Address
First Line : 1941 EAST RD
Second Line :
City : HOUSTON
State : TX
Zip : 77054-6010
Country : US
Telephone Number : 323-217-2219
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2024
Last Update Date : 07/12/2024

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Directions to “ DUCKHYUN JO ” Practice Location

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