Provider Demographics
NPI:1417985300
Name:ILANG-ILANG, FEDERICO P JR (MD)
Entity Type:Individual
Prefix:
First Name:FEDERICO
Middle Name:P
Last Name:ILANG-ILANG
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 ACADIA LN
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-4221
Mailing Address - Country:US
Mailing Address - Phone:469-438-4493
Mailing Address - Fax:972-289-2273
Practice Address - Street 1:801 E. FLORIDA ST.
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6357
Practice Address - Country:US
Practice Address - Phone:432-685-0450
Practice Address - Fax:432-685-0458
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0620207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine