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General NPI Number Information
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NPI Number | 1881072841
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Entity Type | Individual
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Provider Name | DAYTON WONG MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 2504 XENIA ST
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City | PLAINVIEW
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State | TX
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Zip | 79072-1818
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Country | US
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Telephone | 806-296-7881
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Fax | 806-291-5185
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Provider Business Mailing Address
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Address Line | 2215 NASHVILLE AVE
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City | LUBBOCK
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State | TX
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Zip | 79410-1105
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Country | US
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Telephone | 806-725-5844
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Fax | 806-723-6532
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | BP10052706
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | S5523
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License Number State | TX
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