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General NPI Number Information
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NPI Number | 1881079804
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Entity Type | Individual
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Provider Name | MICHAEL JAMES WANG DPT
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Gender | Male
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 8080 STATE HIGHWAY 121 STE 310
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City | MCKINNEY
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State | TX
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Zip | 75070-2900
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Country | US
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Telephone | 972-359-8502
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Fax | 972-359-1749
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | TX
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