Provider Demographics
NPI:1619184900
Name:PENG, XIAO-CONG (MD)
Entity Type:Individual
Prefix:DR
First Name:XIAO-CONG
Middle Name:
Last Name:PENG
Suffix:
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 1:133 LAKE ALUMA DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73121-3401
Mailing Address - Country:US
Mailing Address - Phone:405-290-4337
Mailing Address - Fax:405-290-4082
Practice Address - Street 1:840 RESEARCH PARKWAY
Practice Address - Street 2:DEPT. OF PATHOLOGY, LABCORP AT OKC
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-290-4337
Practice Address - Fax:405-290-4082
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK21385207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology