MEDICARE: STELLA S. KWONG, M.D., 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
1	174400000X	Specialist	G0748	TX

General Provider Information

NPI Number	:	1467544791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STELLA S. KWONG, M.D., P.A.

Provider Business Mailing Address
First Line	:	2825 BELT LINE RD
Second Line	:	SUITE # 103
City	:	GARLAND
State	:	TX
Zip	:	75044-7011
Country	:	US
Telephone Number	:	972-530-5550
Fax Number	:	972-530-3632

Provider Business Practice Location Address
First Line	:	2825 BELT LINE RD
Second Line	:	SUITE # 103
City	:	GARLAND
State	:	TX
Zip	:	75044-7011
Country	:	US
Telephone Number	:	972-530-5550
Fax Number	:	972-530-3632

Authorized Official
Title or Position	:	PRES, SEC, TREAS.
Name	:	DR. STELLA S. KWONG
Credential	:	M.D.
Telephone Number	:	972-530-5550

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/22/2020

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