Provider Information for 1861027617
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JIA HUI WONG
Sex: Female
NPI: 1861027617
Last Updated: 2020-03-11
Certification Date: 2020-03-11
Certification Date: 2020-03-11
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1861027617 | ||||||||||||||
| Enumeration Date | 2020-03-11 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 4334 POLK ST APT 1 HOUSTON, TX 77023-1848 United States Phone: | Fax: | ||||||||||||||
| Primary Practice Address | 1728 BISSONNET ST HOUSTON, TX 77005-1710 United States Phone: 732-947-2628 | Fax: | ||||||||||||||
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