Basic Information
Provider Information
NPI: 1386613545
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHEONG
FirstName: ADRIAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P O BOX 960160
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731960001
CountryCode: US
TelephoneNumber: 8774854474
FaxNumber:  
Practice Location
Address1: 800 W RANDOL MILL RD
Address2:  
City: ARLINGTON
State: TX
PostalCode: 760122504
CountryCode: US
TelephoneNumber: 8175486202
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/17/2006
LastUpdateDate: 05/12/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XE9152TXY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
13743241105TX MEDICAID
81882K01TXBCBS THRU AEMAOTHER
8BT31401TXBCBS THRU SAEMAOTHER
93008419701TXRAILROAD THRU AEMAOTHER
13743240805TX MEDICAID


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