Provider Demographics
NPI:1437110103
Name:CHEUNG, EDSON H (MD)
Entity Type:Individual
Prefix:
First Name:EDSON
Middle Name:H
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:8111 LBJ FREEWAY
Mailing Address - Street 2:STE 835
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251
Mailing Address - Country:US
Mailing Address - Phone:972-437-2577
Mailing Address - Fax:972-644-3810
Practice Address - Street 1:3409 WORTH STREET
Practice Address - Street 2:STE 720
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246
Practice Address - Country:US
Practice Address - Phone:214-821-3603
Practice Address - Fax:214-823-1317
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF9299208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
C14430Medicare UPIN
TX8156N0Medicare PIN