Healthcare Provider Details

I. General information

NPI: 1316242704
Provider Name (Legal Business Name): WENDY HUANG O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2011
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5127 W INDIAN SCHOOL RD STE 161
PHOENIX AZ
85031-2611
US

IV. Provider business mailing address

955 W SOUTHERN AVE STE 101
MESA AZ
85210-4903
US

V. Phone/Fax

Practice location:
  • Phone: 623-245-7014
  • Fax: 623-247-0597
Mailing address:
  • Phone: 480-961-1865
  • Fax: 480-893-8172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3895TX
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT-002924
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: