1568248367 NPI number — TEMPLE PEDIATRICS PLLC

Table of content: TERESA ONG HONG MD (NPI 1629063714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568248367 NPI number — TEMPLE PEDIATRICS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEMPLE PEDIATRICS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568248367
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
903 CANYON CREEK DR.
Provider Second Line Business Mailing Address:
SUITE 120
Provider Business Mailing Address City Name:
TEMPLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76502-3545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-971-2930
Provider Business Mailing Address Fax Number:
512-582-8585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
903 CANYON CREEK DR.
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
TEMPLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76502-3545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-971-2930
Provider Business Practice Location Address Fax Number:
512-582-8585
Provider Enumeration Date:
09/06/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARMON
Authorized Official First Name:
SAMANTHA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
512-971-2930

Provider Taxonomy Codes

  • Taxonomy code: 363LP0222X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)