MEDICARE: DFW ARTHRITIS ASSOCIATES, PA

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	207RR0500X	Rheumatology Physician	L9540	TX

General Provider Information

NPI Number	:	1134301351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DFW ARTHRITIS ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	1120 W CAMPBELL RD
Second Line	:	SUITE 111
City	:	RICHARDSON
State	:	TX
Zip	:	75080-2976
Country	:	US
Telephone Number	:	972-669-0912
Fax Number	:	972-669-1313

Provider Business Practice Location Address
First Line	:	1120 W CAMPBELL RD
Second Line	:	SUITE 111
City	:	RICHARDSON
State	:	TX
Zip	:	75080-2976
Country	:	US
Telephone Number	:	972-669-0912
Fax Number	:	972-669-1313

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. FANG WANG
Credential	:	D.O.
Telephone Number	:	214-663-4029

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	11/29/2007

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