Healthcare Provider Details

I. General information

NPI: 1871563643
Provider Name (Legal Business Name): JONIE HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 SOUTH SUMMER STREET
MARFA TX
79843
US

IV. Provider business mailing address

406 SOUTH SUMMER STREET
MARFA TX
79843
US

V. Phone/Fax

Practice location:
  • Phone: 432-729-1812
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberK9303
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK9303
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: