Provider Demographics
NPI:1770903551
Name:SONGSANGKHAN, JURALUCK (MD)
Entity type:Individual
Prefix:
First Name:JURALUCK
Middle Name:
Last Name:SONGSANGKHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5656 KELLEY ST
Mailing Address - Street 2:LBJ HOSPITAL - DEPT OF OB/GYN RM. 2LD80001
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-1967
Mailing Address - Country:US
Mailing Address - Phone:713-566-5735
Mailing Address - Fax:
Practice Address - Street 1:5757 WOODWAY DR STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1590
Practice Address - Country:US
Practice Address - Phone:713-791-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6911207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology