Healthcare Provider Details

I. General information

NPI: 1669472866
Provider Name (Legal Business Name): ARTHUR C CHENG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 01/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E WHITESTONE BLVD BLDG C
CEDAR PARK TX
78613-5028
US

IV. Provider business mailing address

4515 SETON CENTER PKWY SUITE 215
AUSTIN TX
78759-5290
US

V. Phone/Fax

Practice location:
  • Phone: 512-259-3467
  • Fax: 512-406-7303
Mailing address:
  • Phone: 512-231-5506
  • Fax: 512-406-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036101093
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM5099
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: