Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | H3005 | TX |
NPI | 1164499224 |
---|---|
Provider Name | Dr. Joseph C Chong |
First Address | Houston, TX 77036-4502 |
Second Address | Houston, TX 77036-4502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 16/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C14459 | (02) | TX |