Provider Demographics
NPI:1003898479
Name:ONG, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:ONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5371
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77726-5371
Mailing Address - Country:US
Mailing Address - Phone:409-899-4231
Mailing Address - Fax:409-899-5264
Practice Address - Street 1:2965 HARRISON ST
Practice Address - Street 2:STE 211
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1100
Practice Address - Country:US
Practice Address - Phone:409-899-4231
Practice Address - Fax:409-899-5264
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF2382207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0899080001Medicaid
C20062Medicare UPIN
TX00ER73Medicare ID - Type Unspecified