Individual
RUSSELL DE JONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(210) 916-2985
Mailing address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
33801
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/04/2020
Last updated
08/16/2022
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