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General NPI Number Information
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NPI Number | 1316352842
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Entity Type | Individual
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Provider Name | DIANE LUONG KWON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 7777 FOREST LN
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City | DALLAS
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State | TX
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Zip | 75230-2571
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Country | US
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Telephone | 972-566-6457
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Fax |
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Provider Business Mailing Address
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Address Line | 4253 HUNT DR APT 1710
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City | CARROLLTON
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State | TX
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Zip | 75010-3216
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Country | US
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Telephone | 205-329-4266
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R3373
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 17773
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | R3373
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License Number State | TX
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