Individual
MYRA WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2801 FRANCISCAN DR, BRYAN, TX 77802-2544
(979) 776-3777
Mailing address
2801 FRANCISCAN DR, BRYAN, TX 77802-2544
(979) 776-3777
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD468784
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
T0390
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2014
Last updated
06/23/2021
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