Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | M4660 | TX |
NPI | 1073609293 |
---|---|
Provider Name | Christina W Wong |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-1501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 26/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
184090201 | (05) | TX |
184090202 | CSHCN (01) | TX |
8W7640 | BCBS (01) | TX |
I68852 | (02) |