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General NPI Number Information
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NPI Number | 1124293873
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Entity Type | Individual
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Provider Name | BRANT G WANG M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 1504 TAUB LOOP
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City | HOUSTON
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State | TX
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Zip | 77030-1608
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Country | US
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Telephone | 713-798-1750
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37504
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City | BALTIMORE
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State | MD
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Zip | 21297-3504
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Country | US
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Telephone | 703-321-3700
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Fax | 703-321-3701
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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 | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 0101248829
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | D0067139
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | V1644
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD037901
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License Number State | DC
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Taxonomy #5
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | V1644
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License Number State | TX
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