MEDICARE: WWANG ENTERPRISES PLLC

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	152W00000X	Optometrist	04897T	TX
2	152W00000X	Optometrist

General Provider Information

NPI Number	:	1528272200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WWANG ENTERPRISES PLLC

Provider Business Mailing Address
First Line	:	1400 N COIT RD STE 305
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-6657
Country	:	US
Telephone Number	:	972-562-7015
Fax Number	:	972-548-0469

Provider Business Practice Location Address
First Line	:	1400 N COIT RD STE 305
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-6657
Country	:	US
Telephone Number	:	972-562-7015
Fax Number	:	972-548-0469

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MELISSA MCCLAIN
Credential	:
Telephone Number	:	972-562-7015

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	09/27/2021

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