Provider Demographics
NPI:1306823158
Name:PANG, ALBERT WAIKEUNG (OD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:WAIKEUNG
Last Name:PANG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 CHAPEL HILL BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6392
Mailing Address - Country:US
Mailing Address - Phone:972-250-2733
Mailing Address - Fax:972-248-8072
Practice Address - Street 1:6209 CHAPEL HILL BLVD
Practice Address - Street 2:STE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6392
Practice Address - Country:US
Practice Address - Phone:972-250-2733
Practice Address - Fax:972-248-8072
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3672TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T91282Medicare UPIN
TX8F0903Medicare ID - Type Unspecified