Provider Demographics
NPI:1033268354
Name:ONG, SOON CHAO S (MD)
Entity Type:Individual
Prefix:
First Name:SOON
Middle Name:CHAO S
Last Name:ONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5050 QUORUM DR STE 700
Mailing Address - Street 2:ATTN: ANITA SKIPPER
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-1410
Mailing Address - Country:US
Mailing Address - Phone:972-687-9045
Mailing Address - Fax:972-236-1670
Practice Address - Street 1:5050 QUORUM DR STE 700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-1410
Practice Address - Country:US
Practice Address - Phone:972-687-9045
Practice Address - Fax:972-236-1670
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7867207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035172805Medicaid
TX8J1632Medicare PIN
TXC20061Medicare UPIN
TX035172805Medicaid