Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SO MYUNG PARK DO
NPI 1659951788
Internal Medicine - Nephrology in Dallas, TX

Q: What is So Myung Park's NPI number?

The NPI number for So Myung Park is 1659951788. It was assigned to this individual provider in the NPPES registry on April 13, 2021.

Q: What is So Myung Park's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for So Myung Park was last updated on August 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 13, 2021PECOS Enrolled

1411 N BECKLEY AVE STE 370, DALLAS, TX 75203(214) 366-6460(214) 579-6983 Get Directions Write a Review

NPPES record last updated: August 4, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 4, 2026, Jul 21, 2026, Apr 15, 2021 (3 updates tracked since 2021).

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About So Myung Park Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SO MYUNG PARK DO (NPI 1659951788) is an individual nephrology provider in Dallas, Texas, licensed in Texas (W8073) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1659951788

Entity TypeIndividualFemale

Primary Taxonomy207RN0300X

Provider Legal NameSO MYUNG PARKCredential: DO

Location Address1411 N BECKLEY AVE STE 370Dallas, TX 75203-1513

Mailing Address1505 Lyndon B Johnson Fwy Ste 700Dallas, TX 75234-6065 · (214) 358-2300 · Fax (214) 579-6941

Phone(214) 366-6460

Fax(214) 579-6983

Sole ProprietorNo

Enumeration DateApril 13, 2021

Last NPPES UpdateAugust 4, 20263 updates tracked since enumeration

NPPES CertifiedAugust 4, 2026

✔ NPI 1659951788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in TX · W8073

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

1411 N BECKLEY AVE STE 370, Dallas, TX 75203

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Secondary Practice Locations 2

Location 13604 Live Oak St Ste 100Dallas, TX 75204-6169 · Phone (214) 358-2300 ext. 6300 · Fax (214) 579-6985

Location 21411 N Beckley Ave Ste 268Dallas, TX 75203-1260 · Phone (214) 358-2300 ext. 6460 · Fax (214) 579-6983

Other Identifiers 1

OtherW8073TX · Tx Medical License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

So Myung Park Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75203 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$131.01 typical visit price

range $57.18 – $172.86

Typical copayment $32.75 (range $14.29 – $43.21)

Most-billed visit code 99204

Established Patient

$100.80 typical visit price

range $18.48 – $141.20

Typical copayment $25.20 (range $4.62 – $35.30)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KOSUNARTY FA M.D.

Internal Medicine (Nephrology)