Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | L8552 | TX |
NPI | 1003911322 |
---|---|
Provider Name | Steve Ling Wang JR. |
First Address | Jackson, MS 39225-2926 |
Second Address | Houston, TX 77008-1593 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 29/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
158345202 | (05) | TX |
H84986 | (02) |