Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | F7867 | TX |
NPI | 1033268354 |
---|---|
Provider Name | Soon Chao S Ong |
First Address | Dallas, TX 75254-1410 |
Second Address | Dallas, TX 75254-1410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 29/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
035172805 | (05) | TX |
C20061 | (02) | TX |