MEDICARE: DR. JEANINE EUNKYUNG KWUN MD

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	207Q00000X	Family Medicine Physician	J3333	TX

General Provider Information

NPI Number	:	1922779073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANINE EUNKYUNG KWUN MD

Provider Business Mailing Address
First Line	:	516 FURLONG DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-4120
Country	:	US
Telephone Number	:	512-563-6163
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 E OLTORF ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78741-7500
Country	:	US
Telephone Number	:	512-437-5029
Fax Number	:

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

Provider Enumeration Date	:	09/27/2021
Last Update Date	:	09/27/2021

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