Basic Information
| Provider Information | |||||||||
| NPI: | 1225507106 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUNG | ||||||||
| FirstName: | OCKJU | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 902 S 5TH ST | ||||||||
| Address2: | |||||||||
| City: | CARRIZO SPRINGS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 788344206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8308765263 | ||||||||
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| Practice Location | |||||||||
| Address1: | 902 S 5TH ST | ||||||||
| Address2: | |||||||||
| City: | CARRIZO SPRINGS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 788344206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8308765263 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2018 | ||||||||
| LastUpdateDate: | 11/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP138880 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.