Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | J1249 | TX |
NPI | 1073624292 |
---|---|
Provider Name | Hing-Sheung Eugene Fung |
First Address | Waco, TX 76708-3245 |
Second Address | Waco, TX 76708-3245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 19/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F39853 | (02) | TX |