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NPI Code Detail

MEDICARE: SOON CHAO S ONG M.D.

MEDICARE: SOON CHAO S ONG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology PhysicianF7867TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033268354
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOON CHAO S ONG M.D.
Provider Business Mailing Address
First Line : 5050 QUORUM DR STE 700
Second Line : ATTN: ANITA SKIPPER
City : DALLAS
State : TX
Zip : 75254-1410
Country : US
Telephone Number : 972-687-9045
Fax Number : 972-236-1670
Provider Business Practice Location Address
First Line : 5050 QUORUM DR STE 700
Second Line :
City : DALLAS
State : TX
Zip : 75254-1410
Country : US
Telephone Number : 972-687-9045
Fax Number : 972-236-1670
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 06/29/2012

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Directions to “ SOON CHAO S ONG M.D.” Practice Location

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