Provider Demographics
NPI:1336509967
Name:SANG, MEI
Entity Type:Individual
Prefix:
First Name:MEI
Middle Name:
Last Name:SANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 RIVERSTONE BLVD STE 1201
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5206
Mailing Address - Country:US
Mailing Address - Phone:832-618-6739
Mailing Address - Fax:
Practice Address - Street 1:4502 RIVERSTONE BLVD STE 1201
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5206
Practice Address - Country:US
Practice Address - Phone:832-618-6739
Practice Address - Fax:281-969-7175
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAC01600Medicaid
TX1336509967Medicaid