Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 75993 | GA |
Y | 2080P0204X | Pediatric Emergency Doctor | S2001 | TX |
NPI | 1184966921 |
---|---|
Provider Name | Amy Cheng |
First Address | Dallas, TX 75390-7201 |
Second Address | Dallas, TX 75235-7701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2013 |
Last Update Date | 17/11/2020 |