Provider Demographics
NPI:1841618642
Name:JONATHAN C. CHENG, MD PLLC
Entity Type:Organization
Organization Name:JONATHAN C. CHENG, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-757-9366
Mailing Address - Street 1:1302 WAUGH DR
Mailing Address - Street 2:#824
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-3908
Mailing Address - Country:US
Mailing Address - Phone:626-757-9366
Mailing Address - Fax:
Practice Address - Street 1:1302 WAUGH DR
Practice Address - Street 2:#824
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-3908
Practice Address - Country:US
Practice Address - Phone:626-757-9366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN56192085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty