Provider Demographics
NPI:1558116574
Name:JANG, DAVID S
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:JANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14285 LOST MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3197
Mailing Address - Country:US
Mailing Address - Phone:832-660-8626
Mailing Address - Fax:
Practice Address - Street 1:125 MEDICAL PARK LN OFC PARK
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4905
Practice Address - Country:US
Practice Address - Phone:936-291-3219
Practice Address - Fax:936-291-7206
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program