Healthcare Provider Details

I. General information

NPI: 1831230127
Provider Name (Legal Business Name): FRANK WONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 05/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 E 32ND ST
AUSTIN TX
78722-2211
US

IV. Provider business mailing address

1110 E 32ND ST
AUSTIN TX
78722-2211
US

V. Phone/Fax

Practice location:
  • Phone: 512-320-8388
  • Fax:
Mailing address:
  • Phone: 512-320-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberK8996
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: