Individual
JERRY WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6431 FANNIN ST, MSB 5.170, HOUSTON, TX 77030-1501
(713) 500-7160
Mailing address
6431 FANNIN ST STE JJL 310, HOUSTON, TX 77030-1501
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
W0324
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10080657
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP20084928
TX
Other
Enumeration date
04/29/2022
Last updated
07/29/2025
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