Provider Demographics
NPI:1205093200
Name:CHENG, JASON (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:CHENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 12507
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-0507
Mailing Address - Country:US
Mailing Address - Phone:210-704-2467
Mailing Address - Fax:903-663-7394
Practice Address - Street 1:333 N SANTA ROSA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-704-2467
Practice Address - Fax:903-663-7394
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXQ13722085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology