Provider Demographics
NPI:1972041473
Name:CHONG ENTERPRISES, PLLC.
Entity Type:Organization
Organization Name:CHONG ENTERPRISES, PLLC.
Other - Org Name:VALLEY ANGELS HEALTHCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHONG
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:956-533-4152
Mailing Address - Street 1:5250 RIDGELINE DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3882
Mailing Address - Country:US
Mailing Address - Phone:956-533-4152
Mailing Address - Fax:956-541-4924
Practice Address - Street 1:315 JOSE MARTI BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-2868
Practice Address - Country:US
Practice Address - Phone:956-621-0445
Practice Address - Fax:956-621-0839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125832261QH0100X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care