Individual
NEPENTHE IRWIN FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2825 OAK LAWN AVE UNIT 300309, DALLAS, TX 75219-4102
(844) 389-5711
(877) 880-2039
Mailing address
2825 OAK LAWN AVE UNIT 192749, DALLAS, TX 75219-4688
(510) 683-9500
(877) 880-2039
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
54598
KY
2085R0202X
Diagnostic Radiology Physician
66519
CT
2085R0202X
Diagnostic Radiology Physician
Primary
MD60441577
WA
2085R0202X
Diagnostic Radiology Physician
R9353
TX
2085R0202X
Diagnostic Radiology Physician
TP637
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A762640
—
CA
Enumeration date
10/31/2006
Last updated
09/10/2024
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