Individual
CHUN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3320 LIVE OAK ST, EAST DALLAS HEALTH CENTER, DALLAS, TX 75204-6109
(214) 266-1033
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J7866
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048032905
—
TX
05
—
048032906
—
TX
Enumeration date
01/08/2007
Last updated
12/06/2012
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