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General NPI Number Information
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NPI Number | 1033512827
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Entity Type | Individual
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Provider Name | GUAN-JIE WANG PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 119 HUIZAR REAR A
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City | SAN ANTONIO
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State | TX
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Zip | 78214-2707
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Country | US
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Telephone | 180-054-1495
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Fax |
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Provider Business Mailing Address
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Address Line | 1334 W LULLWOOD AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78201-4519
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Country | US
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Telephone | 210-683-8714
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 51182
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License Number State | TX
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