| Ilsong Jason Chong, M.d.,p.a. | |
|
2410 Ella Blvd Suite B Houston TX 77008-2710 | |
| (713) 861-5000 | |
| (713) 861-5040 |
| Full Name | Ilsong Jason Chong, M.d.,p.a. |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 2410 Ella Blvd, Houston, Texas |
| Authorized Official Name and Position | Ilsong Jason Chong (PRESIDENT) |
| Authorized Official Contact | 7138615000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ilsong Jason Chong, M.d.,p.a. 2410 Ella Blvd Suite B Houston TX 77008-2710 Ph: (713) 861-5000 | Ilsong Jason Chong, M.d.,p.a. 2410 Ella Blvd Suite B Houston TX 77008-2710 Ph: (713) 861-5000 |
| NPI Number | 1063698934 |
|---|---|
| Provider Enumeration Date | 01/10/2008 |
| Last Update Date | 10/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063698934 | NPI | - | NPPES |
| 0089HL | Other | BLUE CROSS | |
| 157500301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | K4025 (Texas) | Primary |
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