Healthcare Provider Details

I. General information

NPI: 1790970796
Provider Name (Legal Business Name): WANSHENG WANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 PRESTON RD
PLANO TX
75024-3214
US

IV. Provider business mailing address

7601 PRESTON RD
PLANO TX
75024-3214
US

V. Phone/Fax

Practice location:
  • Phone: 469-303-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number55252
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberN8872
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number55252
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN8872
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: