MEDICARE: MIN TZU WANG

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
1	207P00000X	Emergency Medicine Physician	Q1764	TX

General Provider Information

NPI Number	:	1083907166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIN TZU WANG

Provider Business Mailing Address
First Line	:	18903 VILLA BERGAMO LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77094-1277
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11490 WESTHEIMER RD STE 1000
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-6853
Country	:	US
Telephone Number	:	626-627-4627
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2011
Last Update Date	:	12/17/2018

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Directions to “ MIN TZU WANG ” Practice Location

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