Active NPI
George Fong
- Physician Assistant
- Conroe, TX
National Provider Identifier
1811319486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA03874
- Practice address
- 200 River Pointe Dr
200
Conroe, TX 77304-2814 - Phone
- (936) 494-4179
- NPI assigned
- Jan 15, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA03874 | TX | Primary |
Addresses
Primary practice location
200 River Pointe Dr
200
Conroe, TX 77304-2814
Mailing address
200 River Pointe Dr
200
Conroe, TX 77304-2814
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA03874 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389744000000",
"number": "1811319486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 RIVER POINTE DR",
"address_2": "200",
"city": "CONROE",
"state": "TX",
"postal_code": "773042814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 RIVER POINTE DR",
"address_2": "200",
"city": "CONROE",
"state": "TX",
"postal_code": "773042814",
"telephone_number": "936-494-4179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "GEORGE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-15",
"last_updated": "2014-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA03874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.