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General NPI Number Information
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NPI Number | 1871638528
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Entity Type | Organization
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Legal Business Name | WANG'S WELLCARE PA
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 1200 BINZ ST SUITE 690
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City | HOUSTON
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State | TX
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Zip | 77004-6900
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Country | US
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Telephone | 713-527-8997
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Fax | 713-527-8999
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Provider Business Mailing Address
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Address Line | PO BOX 20271
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City | HOUSTON
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State | TX
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Zip | 77225-0271
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Country | US
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Telephone | 713-527-8997
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Fax | 713-527-8999
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Authorized Official
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Title or Position | PRESIDENT
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Name | YUN WANG
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Credential | MD
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Telephone | 713-527-8997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | L5607
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License Number State | TX
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