Qijun Song, LSA, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

11-114 Issued in TX

Practice address

475 Bendwood Dr
Houston, TX 77024-8813

Phone

(281) 409-3854

Fax

(832) 201-7900

NPI assigned

Mar 18, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pure Surgical Assistant

  • Surgical Physician Assistant
  • Houston, TX
  • NPI 1902205321
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1982903878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79576",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772799576",
            "telephone_number": "513-312-2223",
            "fax_number": "832-201-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BENDWOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770248813",
            "telephone_number": "281-409-3854",
            "fax_number": "832-201-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "QIJUN",
        "name_prefix": "Ms.",
        "credential": "LSA, SA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-18",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "11-114",
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Song, PA-C
• Jessica Song
• Jin Young Song
• Joanna Song
• Linda Huijie Song, MD
• Qing Song, CAA
• Rui Song, M.D.
• Yun Song, MD
• Tanuntorn Songdechakraiwut, M.D.
• Juraluck Songsangkhan, MD

• Surgical Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Surgical Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.