# HENRY M KWONG, M.D. A PROF MED CORP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HENRY M. KWONG, M.D. A PROF MEDICAL CORP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1922336817
- **Legal business name:** HENRY M. KWONG, M.D. A PROF MEDICAL CORP
- **Authorized official:** HENRY MARK KWONG, M.D. SR. M.D. (PRESIDENT)
- **Authorized official phone:** (337) 367-1247

## Contact information

- **Practice address:** 607 RUE DE BRILLE, NEW IBERIA, LA 70563
- **Practice address phone:** (337) 367-1247
- **Practice address fax:** (337) 365-7496
- **Mailing address:** 607 RUE DE BRILLE, NEW IBERIA, LA 70563
- **Mailing address phone:** (337) 367-1247
- **Mailing address fax:** (337) 365-7496

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 012632 | LA | Yes |

## Other

- **Enumeration date:** 12/03/2009
- **Last updated:** 12/03/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1197980 | — | LA |