Healthcare Provider Details

I. General information

NPI: 1710947742
Provider Name (Legal Business Name): WENDY C HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 04/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 LAS VEGAS BLVD N MIKE O'CALLAGHAN FEDERAL HOSPITAL
NELLIS AFB NV
89191-6601
US

IV. Provider business mailing address

1353 MINUET ST
HENDERSON NV
89052-6434
US

V. Phone/Fax

Practice location:
  • Phone: 702-653-2344
  • Fax:
Mailing address:
  • Phone: 702-332-8102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number11091
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: