Provider Demographics
NPI:1013351840
Name:PAEK, DONGCHUL (DO)
Entity type:Individual
Prefix:
First Name:DONGCHUL
Middle Name:
Last Name:PAEK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 E GRAPEVINE MILLS CIR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-2047
Mailing Address - Country:US
Mailing Address - Phone:888-726-5116
Mailing Address - Fax:888-637-5197
Practice Address - Street 1:2355 E GRAPEVINE MILLS CIR
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-2047
Practice Address - Country:US
Practice Address - Phone:888-726-5116
Practice Address - Fax:888-637-5197
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS4835207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060646710OtherMANCHESTER MEMORIAL HOSPITAL