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General NPI Number Information
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NPI Number | 1154501799
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Entity Type | Individual
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Provider Name | SHINTA JONG M.D
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Gender | Female
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 1020 N COLLINS ST
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City | ARLINGTON
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State | TX
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Zip | 76011-6134
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Country | US
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Telephone | 972-525-9900
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Fax | 469-333-7988
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Provider Business Mailing Address
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Address Line | PO BOX 360541
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City | PITTSBURGH
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State | PA
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Zip | 15251-6541
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Country | US
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Telephone | 972-525-9900
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Fax | 469-333-7988
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 65974-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-121516
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | T5140
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License Number State | TX
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