Healthcare Provider Details

I. General information

NPI: 1851044044
Provider Name (Legal Business Name): LEIGUANG HONG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 ROGER BROOKE DR
FORT SAM HOUSTON TX
78234-4504
US

IV. Provider business mailing address

1320 AUSTIN HWY APT 7309
SAN ANTONIO TX
78209-7520
US

V. Phone/Fax

Practice location:
  • Phone: 210-916-4141
  • Fax:
Mailing address:
  • Phone: 917-528-4470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: