Provider Demographics
NPI:1518040963
Name:SHIM, CHOONG (DC,LAC,DIPLOM)
Entity type:Individual
Prefix:
First Name:CHOONG
Middle Name:
Last Name:SHIM
Suffix:
Gender:M
Credentials:DC,LAC,DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 HIGHLAND DR APT 1115
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4111
Mailing Address - Country:US
Mailing Address - Phone:214-289-5699
Mailing Address - Fax:972-769-7345
Practice Address - Street 1:501 HIGHLAND DR APT 1115
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4111
Practice Address - Country:US
Practice Address - Phone:214-289-5699
Practice Address - Fax:972-769-7345
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10131111NN0400X
TXAC00862171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurology
Not Answered171100000XOther Service ProvidersAcupuncturist