MEDICARE: DIANE LUONG KWON M.D.

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	208000000X	Pediatrics Physician	R3373	TX
2	208M00000X	Hospitalist Physician	R3373	TX
3	208M00000X	Hospitalist Physician	17773	NV

General Provider Information

NPI Number	:	1316352842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE LUONG KWON M.D.

Provider Business Mailing Address
First Line	:	4253 HUNT DR APT 1710
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-3216
Country	:	US
Telephone Number	:	205-329-4266
Fax Number	:

Provider Business Practice Location Address
First Line	:	7777 FOREST LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-2571
Country	:	US
Telephone Number	:	972-566-6457
Fax Number	:

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

Provider Enumeration Date	:	06/23/2014
Last Update Date	:	04/07/2026

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