Provider Demographics
NPI:1316198450
Name:TONG, QIUSHENG (PHD)
Entity Type:Individual
Prefix:MR
First Name:QIUSHENG
Middle Name:
Last Name:TONG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 N LOOP 1604 E # 105-612
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1339
Mailing Address - Country:US
Mailing Address - Phone:210-598-2800
Mailing Address - Fax:210-598-4236
Practice Address - Street 1:1141 N LOOP 1604 E # 105-612
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1339
Practice Address - Country:US
Practice Address - Phone:210-598-2800
Practice Address - Fax:210-598-4236
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246Z00000X, 246ZE0600X
1903246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other