Provider Demographics
NPI:1194726448
Name:HYUN, DANIEL DONG WOOK (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:DONG WOOK
Last Name:HYUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 STONEWALL BND
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-1618
Mailing Address - Country:US
Mailing Address - Phone:210-226-3326
Mailing Address - Fax:210-226-3371
Practice Address - Street 1:3922 WISEMAN BLVD STE 304
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1685
Practice Address - Country:US
Practice Address - Phone:210-226-3326
Practice Address - Fax:210-226-3371
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-03-21
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-04-17
Provider Licenses
StateLicense IDTaxonomies
TXL33462084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164716601Medicaid
8B5918Medicare PIN
TXH64156Medicare UPIN