MEDICARE: TERESA ONG HONG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	11570	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629063714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA ONG HONG MD

Provider Business Mailing Address
First Line	:	2370 CORPORATE CIR STE 300
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7760
Country	:	US
Telephone Number	:	702-910-3950
Fax Number	:	702-786-6650

Provider Business Practice Location Address
First Line	:	653 N TOWN CENTER DR STE 239
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0514
Country	:	US
Telephone Number	:	702-844-4842
Fax Number	:	702-844-4845

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	06/17/2021

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