Su, Jingdong
Su, Jingdong is an individual health care provider with primary practice located at 501 Saunders Ave Ste 200 , Tyler TX 75702-7524. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is his primary health care specialty. Su, Jingdong can be contacted via phone (903) 579-9800.Contact Information
Primary practice address
501 Saunders Ave Ste 200
Tyler TX 75702-7524
Phone: (903) 579-9800
Fax: (903) 592-5988
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | Q8359 | Texas |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | Q8359 | Texas |
Profile Details
| NPI number | 1669607479 |
|---|---|
| LBN Legal business name | Su, Jingdong |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2009 |
| Last updated | Jul 8th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669607479 | NPPES |
| Texas | MEDICAID | 358108401 | |
| Texas | Other | P01701263 |
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