Individual
DR. CHENG CHIEN SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 12TH AVE STE 154, FORT WORTH, TX 76104-3929
(817) 810-9997
(817) 810-9978
Mailing address
1001 12TH AVE STE 154, FORT WORTH, TX 76104-3929
(817) 810-9997
(817) 810-9978
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
H2010
TX
207V00000X
Obstetrics & Gynecology Physician
R0003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0964413
—
TX
Enumeration date
03/23/2006
Last updated
03/13/2017
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