MEDICARE: RUN WANG M.D.

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
1	208800000X	Urology Physician	L5176	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8G3641	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386677268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUN WANG M.D.

Provider Business Mailing Address
First Line	:	6400 FANNIN ST STE 2300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1527
Country	:	US
Telephone Number	:	832-325-7280
Fax Number	:	713-512-7104

Provider Business Practice Location Address
First Line	:	6414 FANNIN ST
Second Line	:	G150
City	:	HOUSTON
State	:	TX
Zip	:	77030-1517
Country	:	US
Telephone Number	:	713-704-2494
Fax Number	:	713-704-6260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	06/20/2023

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Directions to “ RUN WANG M.D.” Practice Location

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