Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 1070 | TX |
NPI | 1407860430 |
---|---|
Provider Name | Dr. Ray W Ng |
First Address | Dallas, TX 75379-7846 |
Second Address | Allen, TX 75013-6103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 04/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
120396004 | (05) | TX |
T92064 | (02) | TX |