Provider Demographics
NPI:1417334954
Name:CHEONG, JILLIANNE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JILLIANNE
Middle Name:
Last Name:CHEONG
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 301173
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75303-1173
Mailing Address - Country:US
Mailing Address - Phone:713-500-3500
Mailing Address - Fax:
Practice Address - Street 1:6700 WEST LOOP S
Practice Address - Street 2:SUITE 500
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4104
Practice Address - Country:US
Practice Address - Phone:713-892-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127993363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily