Active NPI
Myung Park, MD
- Pediatric Cardiology Physician
- Corpus Christi, TX
National Provider Identifier
1093753162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- E5881
- Practice address
- 3533 S Alameda St
Corpus Christi, TX 78411-1721 - Phone
- (361) 694-5086
- Fax
- (361) 855-9518
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | E5881 | TX | Primary |
Addresses
Primary practice location
3533 S Alameda St
Corpus Christi, TX 78411-1721
Mailing address
PO Box 6636
Corpus Christi, TX 78466-6636
Phone (361) 694-5086
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103316 | Other | TX | SUPERIOR HEALTHPLAN |
| 8H9855 | Other | TX | BCBSTX |
| 117824604 | Medicaid | TX | |
| 117824604 | Other | TX | CSHCN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Citizens Medical Center County of Victoria | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Victoria, TX
- NPI 1124052162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1093753162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6636",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784666636",
"telephone_number": "361-694-5086",
"fax_number": "361-855-9518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3533 S ALAMEDA ST",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784111721",
"telephone_number": "361-694-5086",
"fax_number": "361-855-9518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "MYUNG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "TX",
"license": "E5881",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR HEALTHPLAN",
"identifier": "103316",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSTX",
"identifier": "8H9855",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "117824604",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSHCN",
"identifier": "117824604",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.