MEDICARE: SUNU JOSEPH KWON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	16377	TX

General Provider Information

NPI Number	:	1164309241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNU JOSEPH KWON DC

Provider Business Mailing Address
First Line	:	4913 PLANTATION LN
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-5106
Country	:	US
Telephone Number	:	469-432-6878
Fax Number	:

Provider Business Practice Location Address
First Line	:	3251 TRACEWOOD WAY STE 121
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-1747
Country	:	US
Telephone Number	:	817-886-9600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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