Provider Demographics
NPI:1689097248
Name:ONG, LINH V (CRNA)
Entity Type:Individual
Prefix:
First Name:LINH
Middle Name:V
Last Name:ONG
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 DUVAL RD
Mailing Address - Street 2:BLDG 3 SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4275
Mailing Address - Country:US
Mailing Address - Phone:512-485-7200
Mailing Address - Fax:512-485-7224
Practice Address - Street 1:2200 PARK BEND DR
Practice Address - Street 2:BLDG 1, SUITE 201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:512-416-7246
Practice Address - Fax:512-275-2833
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125044367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered