Healthcare Provider Details

I. General information

NPI: 1619045937
Provider Name (Legal Business Name): HUI JUN PARK DC PC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HUI JUN PARK FNP

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21607 STATFIELD GLEN CT
KATY TX
77450-5675
US

IV. Provider business mailing address

21607 STATFIELD GLEN CT
KATY TX
77450-5675
US

V. Phone/Fax

Practice location:
  • Phone: 832-683-4132
  • Fax:
Mailing address:
  • Phone: 832-683-4132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP126718
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: