Provider Demographics
NPI:1124127519
Name:YONGQI YONG, MD, PA
Entity type:Organization
Organization Name:YONGQI YONG, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:YONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-779-8148
Mailing Address - Street 1:PO BOX 740427
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77274-0427
Mailing Address - Country:US
Mailing Address - Phone:713-779-8148
Mailing Address - Fax:281-313-0718
Practice Address - Street 1:9440 BELLAIRE BLVD
Practice Address - Street 2:SUITE #102
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4557
Practice Address - Country:US
Practice Address - Phone:713-779-8148
Practice Address - Fax:713-779-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8588207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150900201Medicaid
TX00498TMedicare PIN