Provider Demographics
NPI:1649292467
Name:TONG, JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:TONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8222 DOUGLAS AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5923
Mailing Address - Country:US
Mailing Address - Phone:214-369-6434
Mailing Address - Fax:214-696-6273
Practice Address - Street 1:1631 LANCASTER DR
Practice Address - Street 2:STE 200
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:817-329-5433
Practice Address - Fax:817-329-5532
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG80894207W00000X
TXM7696207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AQ940OtherBCBS
CAGR0042240Medicaid
G65222Medicare UPIN
CAZZZ18211ZMedicare ID - Type Unspecified
CAGR0042240Medicaid