Individual ProviderJennifer ChongFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address6750 West Loop S Ste 420, Bellaire, TX 77401-4124(713) 266-9955PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer Chong is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1730449729Provider TypeIndividualFull NameChong, JenniferCredentialMDGenderFemaleSole ProprietorYesEnumeration Date5/23/2012Last Updated12/29/2022Contact InformationPractice LocationPractice Address6750 West Loop S Ste 420, Bellaire, TX 77401-4124Phone(713) 266-9955Fax(713) 266-9956Mailing LocationMailing Address6750 West Loop S Ste 420, Bellaire, TX 77401-4124Phone(713) 266-9955Fax(713) 266-9956Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseQ4734TexasCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID8FF556DescriptionOtherIssuerBLUE CROSS BLUE SHIELDTexasID350029001DescriptionMedicaidIssuerUnlistedTexas