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NPI Code Detail

MEDICARE: JEFFREY WANG DO

MEDICARE: JEFFREY WANG DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianOT014145PA
2207V00000XObstetrics & Gynecology PhysicianQ5598TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043502800
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY WANG DO
Provider Business Mailing Address
First Line : 3501 N MACARTHUR BLVD STE 500
Second Line :
City : IRVING
State : TX
Zip : 75062-3675
Country : US
Telephone Number : 972-256-3700
Fax Number : 866-630-6348
Provider Business Practice Location Address
First Line : 3501 N MACARTHUR BLVD STE 500
Second Line :
City : IRVING
State : TX
Zip : 75062-3675
Country : US
Telephone Number : 972-256-3700
Fax Number : 866-630-6348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2011
Last Update Date : 10/16/2020

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Directions to “ JEFFREY WANG DO” Practice Location

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