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General NPI Number Information
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NPI Number | 1861531931
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Entity Type | Individual
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Provider Name | JUDY WONG O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6000 COIT RD SUITE 100
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City | PLANO
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State | TX
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Zip | 75023-5903
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Country | US
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Telephone | 469-467-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 9109 WARM SPRINGS CIR
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City | PLANO
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State | TX
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Zip | 75024-7058
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Country | US
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Telephone | 469-467-8511
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Fax | 469-467-8512
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5472T
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License Number State | TX
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