Individual
DR. EDWARD FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4427 HIGHWAY 6, SUITE L, SUGAR LAND, TX 77478-4424
(281) 313-1810
Mailing address
4427 HIGHWAY 6, SUITE L, SUGAR LAND, TX 77478-4424
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6150TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167183601
—
TX
01
—
81070Q
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/28/2005
Last updated
01/23/2008
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