Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 1420-TEP | WI |
N | 111NI0900X | Internist | 1420-TEP | WI |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | N8068 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | 1420-TEP | WI |
NPI | 1992760276 |
---|---|
Provider Name | Dr. Carl W Tong |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-7105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 29/11/2017 |