TAE J. PARK M.D. NPI 1346297660

NPI Information

  • NPI: 1346297660
  • Provider Name: TAE J. PARK, M.D.
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 306 S HAMPTON RD STE 322
    DALLAS, TX
    ZIP 75208
  • Phone: (469) 501-9205

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NPI Details

Tae J. Park, M.D. is an internal medicine in Dallas, TX with 24 years of experience. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. Tae J. Park, M.D. NPI is 1346297660. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NEW YORK MEDICAL COLLEGE
Graduation Year:2002

The provider's business location address is:

306 S HAMPTON RD STE 322
DALLAS, TX
ZIP 75208-617
Phone: (469) 501-9205
Fax: (469) 629-1179

The NPI 1346297660 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/30/2006 and was last updated on 9/15/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineS1480TEXASYes
2207R00000XInternal MedicineA90047CALIFORNIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100A900470MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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