MEDICARE: DAVID S JANG

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1558116574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID S JANG

Provider Business Mailing Address
First Line	:	14285 LOST MEADOW LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-3197
Country	:	US
Telephone Number	:	832-660-8626
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 MEDICAL PARK LN OFC PARK
Second Line	:
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340-4905
Country	:	US
Telephone Number	:	936-291-3219
Fax Number	:	936-291-7206

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

Provider Enumeration Date	:	04/22/2024
Last Update Date	:	09/12/2024

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Directions to “ DAVID S JANG ” Practice Location

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