Provider Demographics
NPI:1902938269
Name:CHUNG, SUNG (LAC)
Entity Type:Individual
Prefix:
First Name:SUNG
Middle Name:
Last Name:CHUNG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20701 KINGSLAND BLVD
Mailing Address - Street 2:111
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2709
Mailing Address - Country:US
Mailing Address - Phone:281-579-1561
Mailing Address - Fax:
Practice Address - Street 1:20701 KINGSLAND BLVD
Practice Address - Street 2:111
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2709
Practice Address - Country:US
Practice Address - Phone:281-579-1561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00991171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist