Provider Demographics
NPI:1609130475
Name:CHAROENPONG, PRANGTHIP (MD)
Entity Type:Individual
Prefix:DR
First Name:PRANGTHIP
Middle Name:
Last Name:CHAROENPONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 CAMBRIDGE ST.
Mailing Address - Street 2:SUITE 8A, BCM902
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-798-2482
Mailing Address - Fax:
Practice Address - Street 1:6620 MAIN ST STE 1475
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2347
Practice Address - Country:US
Practice Address - Phone:832-355-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA155505207RC0200X, 207RP1001X
LA322020207R00000X, 207RC0200X, 207RP1001X
TXU4762207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease