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General NPI Number Information
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NPI Number | 1700508801
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Entity Type | Individual
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Provider Name | CATHERINE JOAN WANG
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Gender | Female
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 210 E PLEASANT RUN RD
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City | DESOTO
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State | TX
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Zip | 75115-3938
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Country | US
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Telephone | 972-274-7008
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Fax |
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Provider Business Mailing Address
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Address Line | 3355 BLACKBURN ST APT 8401
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City | DALLAS
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State | TX
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Zip | 75204-1539
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Country | US
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Telephone | 832-797-7070
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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 | 70872
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License Number State | TX
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