Individual
DR. JINGDONG SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 SAUNDERS AVE STE 200, TYLER, TX 75702-7524
(903) 579-9800
(903) 592-5988
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q8359
TX
207RH0003X
Hematology & Oncology Physician
Primary
Q8359
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358108401
—
TX
01
—
P01701263
RAILROAD
TX
Enumeration date
05/22/2009
Last updated
07/08/2023
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