Healthcare Provider Details

I. General information

NPI: 1023931466
Provider Name (Legal Business Name): BYUNG KOOK JUNG DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18511 HIGHLANDER MEDICS ST WBAMC FT BLISS
APO AA
79918
US

IV. Provider business mailing address

13292 COLDHAM ST
HORIZON CITY TX
79928-7565
US

V. Phone/Fax

Practice location:
  • Phone: 404-547-3056
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number1186583
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: