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General NPI Number Information
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NPI Number | 1932150182
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Entity Type | Organization
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Legal Business Name | SAM SEUNGHAE AHN, MD,PA
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 221 W COLORADO BLVD SUITE 625
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City | DALLAS
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State | TX
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Zip | 75208-2363
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Country | US
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Telephone | 214-946-5165
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Fax | 214-946-4876
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Provider Business Mailing Address
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Address Line | 221 W COLORADO BLVD SUITE 625
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City | DALLAS
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State | TX
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Zip | 75208-2363
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Country | US
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Telephone | 214-946-5165
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Fax | 214-946-4876
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Authorized Official
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Title or Position | OWNER
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Name | SAM SEUNGHAE AHN
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Credential | MD
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Telephone | 214-946-5165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | F1333
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License Number State | TX
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