Provider Demographics
NPI:1114943362
Name:KIN WONG
Entity Type:Organization
Organization Name:KIN WONG
Other - Org Name:SOUTHWESTERN EMERGENCY PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIN
Authorized Official - Middle Name:SING
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:915-496-9600
Mailing Address - Street 1:1221 N COTTON ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3015
Mailing Address - Country:US
Mailing Address - Phone:915-496-9600
Mailing Address - Fax:
Practice Address - Street 1:1221 N COTTON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3015
Practice Address - Country:US
Practice Address - Phone:915-496-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0038NJOtherBC/BS OF TEXAS
TX0038NJOtherBC/BS OF TEXAS