Healthcare Provider Details

I. General information

NPI: 1639136310
Provider Name (Legal Business Name): WILSON H HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 PINTO LANE STE 200
LAS VEGAS NV
89106
US

IV. Provider business mailing address

2011 PINTO LANE STE 200
LAS VEGAS NV
89106
US

V. Phone/Fax

Practice location:
  • Phone: 702-382-3200
  • Fax: 702-382-3575
Mailing address:
  • Phone: 702-382-3200
  • Fax: 702-382-3575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number76472
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number9761
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: