Provider Demographics
NPI:1225173073
Name:TANG-WING, PHYLLIS C (OD)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:C
Last Name:TANG-WING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:C
Other - Last Name:TANG-WING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:1520 W BAY AREA BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2600
Mailing Address - Country:US
Mailing Address - Phone:713-995-0042
Mailing Address - Fax:713-995-0548
Practice Address - Street 1:1520 W BAY AREA BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2600
Practice Address - Country:US
Practice Address - Phone:713-995-0042
Practice Address - Fax:713-995-0548
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2941T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2941TOtherTEXAS OPTOMETRY LICENSE