Provider Demographics
NPI:1710292859
Name:LIONG, URSULA AURORA PO (MD)
Entity Type:Individual
Prefix:DR
First Name:URSULA AURORA
Middle Name:PO
Last Name:LIONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:URSULA AURORA
Other - Middle Name:DOLLA
Other - Last Name:PO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5958
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5958
Mailing Address - Country:US
Mailing Address - Phone:956-362-8677
Mailing Address - Fax:
Practice Address - Street 1:5501 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5503
Practice Address - Country:US
Practice Address - Phone:956-362-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9218207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342974802Medicaid