Provider Demographics
NPI:1326237868
Name:WENTIAN HUANG, MD, PHD, P.C.
Entity Type:Organization
Organization Name:WENTIAN HUANG, MD, PHD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, PHD.
Authorized Official - Prefix:
Authorized Official - First Name:WENTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-530-5550
Mailing Address - Street 1:3475 COLLINS BLVD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-3621
Mailing Address - Country:US
Mailing Address - Phone:972-530-5550
Mailing Address - Fax:972-530-3632
Practice Address - Street 1:3475 COLLINS BLVD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-3621
Practice Address - Country:US
Practice Address - Phone:972-530-5550
Practice Address - Fax:972-530-3632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1153207R00000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W7364OtherBCBS
TXP00336515OtherRR MEDICARE
TX180748902Medicaid
TX8G6136Medicare PIN
TXP00336515OtherRR MEDICARE