Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | A120264 | CA |
Y | 207PE0004X | Emergency Medical Services | N6092 | TX |
NPI | 1063652147 |
---|---|
Provider Name | Sean Wang |
First Address | San Antonio, TX 78258-4871 |
Second Address | San Antonio, TX 78229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2009 |
Last Update Date | 13/12/2013 |