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General NPI Number Information
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NPI Number | 1265764328
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Entity Type | Organization
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Legal Business Name | ALBERT M. ONG M.D., P.A.
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 740 HOSPITAL DR STE 100
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City | BEAUMONT
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State | TX
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Zip | 77701-4663
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Country | US
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Telephone | 409-832-8608
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13036
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City | BEAUMONT
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State | TX
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Zip | 77726-3036
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Country | US
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Telephone | 409-832-8608
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT MICHAEL ONG I
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Credential | M.D.
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Telephone | 409-832-8608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | M3052
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License Number State | TX
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