Provider Demographics
NPI:1861491284
Name:ONGHAI, PHILIP G (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:G
Last Name:ONGHAI
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 1:4910 GOLDEN QUAIL STE 170
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1770
Mailing Address - Country:US
Mailing Address - Phone:210-670-7509
Mailing Address - Fax:210-485-1343
Practice Address - Street 1:4910 GOLDEN QUAIL STE 170
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1770
Practice Address - Country:US
Practice Address - Phone:210-670-7509
Practice Address - Fax:210-485-1343
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1604174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z511OtherMEDICARE PROVIDER NUMBER
TX140835301Medicaid
TX140835301Medicaid
TX00835MMedicare PIN