Healthcare Provider Details

I. General information

NPI: 1366650772
Provider Name (Legal Business Name): CHRISTINA JEAN KUO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4708 DEXTER DR STE 400
PLANO TX
75093-5288
US

IV. Provider business mailing address

4708 DEXTER DR STE 400
PLANO TX
75093-5288
US

V. Phone/Fax

Practice location:
  • Phone: 972-993-5050
  • Fax: 972-993-5051
Mailing address:
  • Phone: 972-993-5050
  • Fax: 972-993-5051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN1374
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: