Healthcare Provider Details

I. General information

NPI: 1013741388
Provider Name (Legal Business Name): JI WOO HWANG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 W I 20 STE 204
ARLINGTON TX
76017-1678
US

IV. Provider business mailing address

2310 W I 20 STE 204
ARLINGTON TX
76017-1678
US

V. Phone/Fax

Practice location:
  • Phone: 817-466-7276
  • Fax: 844-283-4950
Mailing address:
  • Phone: 817-466-7276
  • Fax: 844-283-4950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1398213
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: