Individual
DR. JENELLE C. WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3405 MIDWAY RD STE 650, PLANO, TX 75093-8139
(972) 473-7777
(972) 473-7780
Mailing address
3405 MIDWAY RD STE 650, PLANO, TX 75093-8139
(972) 473-7777
(972) 473-7780
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K4837
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
752914840
TAX ID
TX
Enumeration date
09/21/2006
Last updated
05/11/2021
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