Basic Information
| Provider Information | |||||||||
| NPI: | 1396709242 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BONG MUI MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13480 VETERANS MEMORIAL DR | ||||||||
| Address2: | R-1 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770141696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812871600 | ||||||||
| FaxNumber: | 2815871601 | ||||||||
| Practice Location | |||||||||
| Address1: | 13480 VETERANS MEMORIAL DR | ||||||||
| Address2: | R-1 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770141696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812871600 | ||||||||
| FaxNumber: | 2815871601 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2006 | ||||||||
| LastUpdateDate: | 03/21/2011 | ||||||||
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| AuthorizedOfficialLastName: | MUI | ||||||||
| AuthorizedOfficialFirstName: | TAMMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2815871600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | M4384 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.