Healthcare Provider Details

I. General information

NPI: 1942093638
Provider Name (Legal Business Name): HANNAH CHUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2025
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 E COPELAND RD STE 300
ARLINGTON TX
76011-4910
US

IV. Provider business mailing address

520 WINDING RIDGE TRL
SOUTHLAKE TX
76092-1369
US

V. Phone/Fax

Practice location:
  • Phone: 817-505-2575
  • Fax:
Mailing address:
  • Phone: 217-766-1496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: