Organization
KWONG ORTHOPEDICS AND SPORTS MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER C KWONG M.D. (PHYSICIAN/OWNER)
(817) 399-9997
Entity
Organization
Contact information
Practice address
1600 CENTRAL DR, SUITE 200, BEDFORD, TX 76022-6000
(817) 399-9997
(817) 399-0694
Mailing address
1600 CENTRAL DR, SUITE 200, BEDFORD, TX 76022-6000
(817) 399-9997
(817) 399-0694
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0028EK
BLUE CROSS BLUE SHIELD
—
01
—
0154920267
PACIFICARE
TX
01
—
2285320
AETNA
TX
01
—
8215807004
CIGNA
TX
Enumeration date
11/06/2009
Last updated
04/29/2011
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