So Myung Park, DO

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

W8073 Issued in TX

Practice address

1411 N Beckley Ave Ste 370
Dallas, TX 75203-1513

Phone

(214) 366-6460

Fax

(214) 579-6983

NPI assigned

Apr 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Dallas Nephrology Associates

  • Nephrology Physician
  • Dallas, TX
  • NPI 1861440109
  NPD
• Dallas Nephrology Associates

  dba Dallas Nephrology Associates Vascular Center Dallas

  • Ambulatory Surgical Clinic/Center
  • Dallas, TX
  • NPI 1053634030
  NPD (past)

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1659951788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 LYNDON B JOHNSON FWY STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752346065",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE STE 370",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031513",
            "telephone_number": "214-366-6460",
            "fax_number": "214-579-6983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3604 Live Oak St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752046169",
            "country_code": "US",
            "telephone_number": "214-358-2300 x6300",
            "fax_number": "214-579-6985",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1411 N Beckley Ave Ste 268",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752031260",
            "country_code": "US",
            "telephone_number": "214-358-2300 x6460",
            "fax_number": "214-579-6983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SO MYUNG",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "W8073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL LICENSE",
            "identifier": "W8073",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nuri Park, NP
• Rachel Park, DO
• Sang Park
• Sanghoon Park, MD
• Sangwook Park
• Stephen Sangjin Park, M.D.
• Sungjin Park
• Susanna Park
• Tae J. Park, M.D.
• Yong Jong Park, DDS

• Nephrology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.