Provider Demographics
NPI:1114567740
Name:WANG, HAN (DAOM, LAC)
Entity Type:Individual
Prefix:
First Name:HAN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 SAN FELIPE ST STE C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2700
Mailing Address - Country:US
Mailing Address - Phone:832-975-7045
Mailing Address - Fax:832-344-3848
Practice Address - Street 1:6415 SAN FELIPE ST STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-2700
Practice Address - Country:US
Practice Address - Phone:832-582-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-11
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01903171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171100000XOtherNPPES