Individual
MARY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 MEDICAL PKWY, LAKEWAY, TX 78738-5621
(512) 571-5000
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD198522
OR
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
T6417
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
04/13/2015
Last updated
07/31/2024
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