Provider Demographics
NPI:1073190286
Name:HONG, JULIE (DO)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1759 BROAD PARK CIRCLE S
Mailing Address - Street 2:SUITE 201 AND 205
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063
Mailing Address - Country:US
Mailing Address - Phone:682-341-3910
Mailing Address - Fax:682-400-1288
Practice Address - Street 1:1759 BROAD PARK CIRCLE S
Practice Address - Street 2:SUITE 201 AND 205
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:682-341-3910
Practice Address - Fax:682-400-1288
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXU9962208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics