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General NPI Number Information
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NPI Number | 1295052504
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Entity Type | Individual
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Provider Name | JASON T WANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 11548 BELLAIRE BLVD
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City | HOUSTON
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State | TX
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Zip | 77072-2448
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Country | US
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Telephone | 281-973-0024
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Fax | 281-973-0203
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Provider Business Mailing Address
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Address Line | 419 COLE ST
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City | WEBSTER
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State | TX
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Zip | 77598-5017
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Country | US
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Telephone | 281-973-0024
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Fax | 281-973-0203
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | P3095
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License Number State | TX
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