Provider Demographics
NPI:1508021544
Name:CHENG, JEDSIAN (MD/MPH)
Entity type:Individual
Prefix:DR
First Name:JEDSIAN
Middle Name:
Last Name:CHENG
Suffix:
Gender:M
Credentials:MD/MPH
Other - Prefix:DR
Other - First Name:JED-SIAN
Other - Middle Name:
Other - Last Name:CHENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD/MPH
Mailing Address - Street 1:6560 FANNIN ST STE 1554
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2714
Mailing Address - Country:US
Mailing Address - Phone:713-796-1500
Mailing Address - Fax:832-649-3298
Practice Address - Street 1:6560 FANNIN ST STE 1554
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2714
Practice Address - Country:US
Practice Address - Phone:713-796-1500
Practice Address - Fax:832-649-3298
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255303208800000X
TXR8169208800000X
IL036144098208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036144098OtherSTATE LICENSE