Healthcare Provider Details

I. General information

NPI: 1336104603
Provider Name (Legal Business Name): WEI-LI HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 05/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 EXECUTIVE CENTER DR SUITE 250
AUSTIN TX
78731-1678
US

IV. Provider business mailing address

3445 EXECUTIVE CENTER DR SUITE 250
AUSTIN TX
78731-1678
US

V. Phone/Fax

Practice location:
  • Phone: 512-579-4000
  • Fax: 512-439-2814
Mailing address:
  • Phone: 512-579-4000
  • Fax: 512-439-2814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberJ7007
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: