Kevin Hyeun Park, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

71171 Issued in TX

Practice address

5721 Williams Dr
Georgetown, TX 78633-2196

Phone

(512) 942-6400

NPI assigned

Sep 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Round Rock, TX
  • NPI 1740297787
  NPD (past)

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671321600000",
    "number": "1558085316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 JUSTIN LN APT 2130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787572652",
            "telephone_number": "806-577-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332196",
            "telephone_number": "512-942-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KEVIN",
        "middle_name": "HYEUN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-12-18",
        "certification_date": "2022-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "71171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Horton, PH.D., P.C.
• Jitenkumar Harshadbhai Panchal, MD
• Rachel Pantoja, M.D.
• Jihee Park, D.M.D.
• Joseph Park, D.D.S.
• Kony Park, D.M.D
• Kirsten Rene Parker
• Rachael Parker
• Evalina Parlier, RBT
• Parmer Modern Dentistry and Orthodontics, PC

• Pharmacist in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2022; 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.