MEDICARE: DR. WEN S LAI 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	207R00000X	Internal Medicine Physician	J8631	TX

General Provider Information

NPI Number	:	1689698870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WEN S LAI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7208
Country	:	US
Telephone Number	:	214-964-0600
Fax Number	:	214-964-0638

Provider Business Practice Location Address
First Line	:	701 TUSCAN DR
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-4133
Country	:	US
Telephone Number	:	214-964-0600
Fax Number	:	214-964-0638

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	05/13/2019

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