| Chong Enterprises, Pllc. | |
|
315 Jose Marti Blvd Brownsville TX 78526-2868 | |
| (956) 621-0445 | |
| (956) 621-0839 |
| Full Name | Chong Enterprises, Pllc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 315 Jose Marti Blvd, Brownsville, Texas |
| Authorized Official Name and Position | Samuel Chong (OWNER) |
| Authorized Official Contact | 9565334152 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chong Enterprises, Pllc. 5250 Ridgeline Dr Brownsville TX 78526-3882 Ph: (956) 533-4152 | Chong Enterprises, Pllc. 315 Jose Marti Blvd Brownsville TX 78526-2868 Ph: (956) 621-0445 |
| NPI Number | 1972041473 |
|---|---|
| Provider Enumeration Date | 02/03/2017 |
| Last Update Date | 02/03/2017 |
| Medicare PECOS PAC ID | 4082998547 |
|---|---|
| Medicare Enrollment ID | O20170228001657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972041473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | AP125832 (Texas) | Secondary |
| 261QH0100X | Clinic/center - Health Service | AP125832 (Texas) | Primary |
| Provider Name | Paul A Lenz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669446175 PECOS PAC ID: 8820022551 Enrollment ID: I20110323000532 |
| Provider Name | Graciela Ybarra Chong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093119711 PECOS PAC ID: 6800854282 Enrollment ID: I20170228001823 |
| Provider Name | Samuel Lee Chong |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083000111 PECOS PAC ID: 0345504429 Enrollment ID: I20180426001838 |
| Provider Name | Brandon Lee Chong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790426351 PECOS PAC ID: 1759822968 Enrollment ID: I20240916000871 |
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