Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | P9105 | TX |
NPI | 1013117530 |
---|---|
Provider Name | Dr. Bryan Allan Ong |
First Address | Dallas, TX 75247-4228 |
Second Address | North Richland Hills, TX 76180-8302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 25/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8EN071 | BCBS TX (01) | TX |