Wong, Kevan L
Wong, Kevan L is an individual health care provider with primary practice located at 4144 N Central Expy Ste 360, Dallas TX 75204-2156. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Wong, Kevan L can be contacted via phone (214) 827-7460.Contact Information
Primary practice address
4144 N Central Expy Ste 360
Dallas TX 75204-2156
Phone: (214) 827-7460
Fax: (214) 826-6858
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | L1243 | Texas |
Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | L1243 | Texas |
Profile Details
NPI number | 1336144500 |
---|---|
LBN Legal business name | Wong, Kevan L |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 15th, 2005 |
Last updated | Nov 3rd, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1336144500 | NPPES |
Texas | Other | 8EH854 | BCBS |
Texas | Other | P01446832 | BCBS |
Texas | MEDICAID | 040825401 | BCBS |
Texas | MEDICAID | 040825404 | BCBS |
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