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General NPI Number Information
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NPI Number | 1063652147
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Entity Type | Individual
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Provider Name | SEAN WANG MD
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Gender | Male
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 7703 FLOYD CURL DRIVE, MS 7736 UTHSCSA, DEPARTMENT OF EMERGENCY MEDICINE
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-567-5176
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Fax | 210-567-4793
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Provider Business Mailing Address
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Address Line | 2 IMPALA WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4871
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Country | US
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Telephone | 210-567-5176
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Fax | 210-567-4793
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | N6092
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | A120264
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License Number State | CA
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