Provider Demographics
NPI:1669570255
Name:AUNG, SOE M (MD)
Entity type:Individual
Prefix:
First Name:SOE
Middle Name:M
Last Name:AUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14527 RIDGETOP TER
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1037
Mailing Address - Country:US
Mailing Address - Phone:410-740-2370
Mailing Address - Fax:410-740-1518
Practice Address - Street 1:14527 RIDGETOP TER
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1037
Practice Address - Country:US
Practice Address - Phone:512-477-5337
Practice Address - Fax:512-682-6299
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM06482084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176460704Medicaid
TX8AP900OtherBCBS OF TX
TXP00635691OtherRAILROAD MEDICARE
TXP00635691OtherRAILROAD MEDICARE