Organization
ILSONG JASON CHONG, M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILSONG JASON CHONG M.D. (PRESIDENT)
(713) 861-5000
Entity
Organization
Contact information
Practice address
2410 ELLA BLVD, SUITE B, HOUSTON, TX 77008-2710
(713) 861-5000
(713) 861-5040
Mailing address
2410 ELLA BLVD, SUITE B, HOUSTON, TX 77008-2710
(713) 861-5000
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
K4025
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0089HL
BLUE CROSS
—
05
—
157500301
—
TX
Enumeration date
01/10/2008
Last updated
10/14/2009
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