Individual
TIEN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6560 FANNIN ST, STE 750, HOUSTON, TX 77030-2727
(713) 524-3434
(713) 524-3220
Mailing address
6560 FANNIN ST, STE 750, HOUSTON, TX 77030-2727
(713) 524-3434
(713) 524-3220
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
H3961
TX
207WX0107X
Retina Specialist (Ophthalmology) Physician
H3961
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10019568
AMERIGROUP
TX
05
—
101319501
—
TX
05
—
101319502
—
TX
05
—
1534421
—
LA
01
—
19422
OPTICARE
TX
01
—
26010
SELECTCARE OF TEXAS
TX
01
—
4310136
AETNA
TX
01
—
80G068
BLUE SHIELD
TX
01
—
E89756
STERLING OPTION ONE
TX
01
—
H3961
UNICARE
TX
Enumeration date
09/20/2006
Last updated
03/29/2017
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