Provider Demographics
NPI:1003092644
Name:KWONG, STELLA SUK-YEE (MD)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:SUK-YEE
Last Name:KWONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2825 BELT LINE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-7011
Mailing Address - Country:US
Mailing Address - Phone:972-530-5550
Mailing Address - Fax:972-530-3632
Practice Address - Street 1:2825 BELT LINE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-7011
Practice Address - Country:US
Practice Address - Phone:972-530-5550
Practice Address - Fax:972-530-3632
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0748207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB24181Medicare UPIN
TX00SF84Medicare PIN