Individual
DR. DAN L. PONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-6431
(409) 772-7150
(409) 747-2850
Mailing address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
R4455
TX
2085R0202X
Diagnostic Radiology Physician
Primary
R4455
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
398623403
—
TX
Enumeration date
04/29/2013
Last updated
10/30/2024
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