Healthcare Provider Details

I. General information

NPI: 1023209327
Provider Name (Legal Business Name): SUNG HYUN PAEK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID SUNG PAEK M.D.

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 GEORGE BUSH HWY STE 250
RICHARDSON TX
75082-3552
US

IV. Provider business mailing address

3001 GEORGE BUSH HWY STE 250
RICHARDSON TX
75082-3552
US

V. Phone/Fax

Practice location:
  • Phone: 214-343-6663
  • Fax: 214-343-2814
Mailing address:
  • Phone: 214-343-6663
  • Fax: 214-343-2814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA101637
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberS2449
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: