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NPI Code Detail

MEDICARE: WAH JEW KONG DDS

MEDICARE:   WAH JEW KONG  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist15339TX

General Provider Information

NPI Number : 1073640462
Entity Type Code : Individual
Provider Name (Legal Business Name) : WAH JEW KONG DDS
Provider Business Mailing Address
First Line : PO BOX 404
Second Line : 2205 CLINTON DR
City : GALENA PARK
State : TX
Zip : 77547
Country : US
Telephone Number : 713-674-0550
Fax Number : 713-674-2299
Provider Business Practice Location Address
First Line : 2205 CLINTON DR
Second Line :
City : GALENA PARK
State : TX
Zip : 77547
Country : US
Telephone Number : 713-674-0550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/08/2007

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Directions to “ WAH JEW KONG DDS” Practice Location

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