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NPI Code Detail

MEDICARE: DR. GENE WONG & ASSOCIATES, P.A.

MEDICARE: DR. GENE WONG & ASSOCIATES, P.A.
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
1152W00000XOptometrist7686TGTX

General Provider Information

NPI Number : 1134412190
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. GENE WONG & ASSOCIATES, P.A.
Provider Business Mailing Address
First Line : 745 W HIDDEN CREEK PKWY
Second Line : #222
City : BURLESON
State : TX
Zip : 76028-5793
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9500 CLIFFORD ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76108-4403
Country : US
Telephone Number : 817-367-7100
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. GENE WONG
Credential : O.D.
Telephone Number : 757-746-3536
Provider Enumeration Date : 05/24/2011
Last Update Date : 05/24/2011

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