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NPI Code Detail

MEDICARE: DR. JOSEPH KISE CHUNG M.D.

MEDICARE: DR. JOSEPH KISE CHUNG 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
1207Q00000XFamily Medicine Physician036106892IL
2207Q00000XFamily Medicine Physician2020-04159NC
3207Q00000XFamily Medicine PhysicianU9493TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
204532170OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1932187416
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH KISE CHUNG M.D.
Provider Business Mailing Address
First Line : 3116 MYRTICE DR
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75022-0968
Country : US
Telephone Number : 708-359-2919
Fax Number :
Provider Business Practice Location Address
First Line : 1300 S FIELDER RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76013-2348
Country : US
Telephone Number : 817-277-2221
Fax Number : 817-459-5253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 12/04/2025

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