Individual
DR. PENNY FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MBA
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
S2767
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402260001
—
TX
01
—
402260002
CSHCN (MEDICAID)
TX
01
—
8LP967
BCBS
TX
Enumeration date
06/06/2014
Last updated
11/01/2019
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