Individual
JOHN C WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
L3866
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10006843
AMERIGROUP
TX
05
—
1527616-01
—
TX
01
—
340020371
MEDICARE RAILROAD
TX
01
—
7430373
AETNA
TX
01
—
8G4510
BLUECROSS/BLUESHIELD
TX
Enumeration date
04/10/2006
Last updated
01/22/2016
Update your record
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