Provider Demographics
NPI:1912972845
Name:CHA, CHOON HONG (MD)
Entity Type:Individual
Prefix:DR
First Name:CHOON
Middle Name:HONG
Last Name:CHA
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 1:10404 EASTLAWN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5308
Mailing Address - Country:US
Mailing Address - Phone:214-496-0606
Mailing Address - Fax:
Practice Address - Street 1:10404 EASTLAWN DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-5308
Practice Address - Country:US
Practice Address - Phone:214-496-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH75942084N0400X
CAA515442084N0400X
OK206222084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044601502Medicaid
TX044601502Medicaid