Jennifer S. Kwak, M.D.,P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L4029 Issued in TX

Legal business name

JENNIFER S. KWAK, M.D.,P.A.

Practice address

15040 Fairfield Village Square Dr
Suite 150
Cypress, TX 77433-5952

Phone

(281) 304-5100

Fax

(281) 304-5191

NPI assigned

Feb 16, 2007

Last updated

Sep 20, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jennifer Soohyun Kwak, M.D.NPI 1427045145

Title

Owner

Phone

(281) 304-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Soohyun Kwak, M.D.

  • Family Medicine Physician
  • Cypress, TX
  • NPI 1427045145
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1477697050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15040 FAIRFIELD VILLAGE SQUARE DR",
            "address_2": "SUITE 150",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774335952",
            "telephone_number": "281-304-5100",
            "fax_number": "281-304-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15040 FAIRFIELD VILLAGE SQUARE DR",
            "address_2": "SUITE 150",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774335952",
            "telephone_number": "281-304-5100",
            "fax_number": "281-304-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER S. KWAK, M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "KWAK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "SOOHYUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-304-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L4029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR PRIVATE PRACTICE",
            "identifier": "NPI 1427045145",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• JB at-Home Care LLC
• JB's Home Health Agency LLC
• Cherry Charlette Jefferson, RN BSN
• Nina Marie Jenkins, LMT, MTI
• Jenni Berry Counseling, PLLC
• Sonia Jennings
• Jessica Jensen, LPC
• Jennifer Bimeler Jessen, MA, LPC, LCDC
• Martesha Jessie
• Brian Christopher Jestel, D.C.

• Family Medicine Physician in Cypress, TX
• Providers in Cypress, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.