Basic Information
Provider Information
NPI: 1275943227
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JI
FirstName: HONGZHAO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2001 INWOOD RD
Address2:  
City: DALLAS
State: TX
PostalCode: 753907202
CountryCode: US
TelephoneNumber: 2145908058
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/30/2014
LastUpdateDate: 02/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000XS1618TXY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


Home