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General NPI Number Information
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NPI Number | 1326183351
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Entity Type | Individual
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Provider Name | WAN HIN HUMPHREY HO DDS
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Gender | Male
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 12854 RESEARCH BLVD
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City | AUSTIN
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State | TX
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Zip | 78750-3222
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Country | US
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Telephone | 512-831-7918
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Fax | 512-831-7919
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Provider Business Mailing Address
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Address Line | 5609 CLARION CV
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City | AUSTIN
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State | TX
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Zip | 78746-1838
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Country | US
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Telephone | 512-694-7678
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Fax | 512-582-9118
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 0025291
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License Number State | TX
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