Healthcare Provider Details

I. General information

NPI: 1922638139
Provider Name (Legal Business Name): JANG NGA ZENG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 GASTON AVE STE 360
DALLAS TX
75246-1903
US

IV. Provider business mailing address

5980 KINGFISHER BLVD
WESTLAKE FL
33470
US

V. Phone/Fax

Practice location:
  • Phone: 214-820-7246
  • Fax: 214-310-0421
Mailing address:
  • Phone: 561-809-3838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9112456
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: