Individual
JIAN WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4100 FAIRWAY DR, SUITE 300, CARROLLTON, TX 75010-6525
(972) 492-8880
(972) 492-8818
Mailing address
4100 FAIRWAY DR, SUITE 300, CARROLLTON, TX 75010-6525
(972) 492-8880
(972) 492-8818
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K6737
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1075004-14
—
TX
01
—
84677F
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/09/2005
Last updated
01/07/2013
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