Provider Demographics
NPI:1043405426
Name:WILLIE TEO ONG, MD PA
Entity Type:Organization
Organization Name:WILLIE TEO ONG, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER/CREDENITALING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESMERALDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-548-0077
Mailing Address - Street 1:844 CENTRAL BLVD STE 370
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7512
Mailing Address - Country:US
Mailing Address - Phone:956-548-0077
Mailing Address - Fax:956-548-2312
Practice Address - Street 1:844 CENTRAL BLVD STE 370
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7512
Practice Address - Country:US
Practice Address - Phone:956-548-0077
Practice Address - Fax:956-548-2312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1094207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDD1638OtherRAILROAD MEDICARE
TX00933WMedicare PIN