Provider Demographics
NPI:1346730066
Name:HUANG, SIMO (MD)
Entity Type:Individual
Prefix:
First Name:SIMO
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4646 WILD INDIGO ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7189
Mailing Address - Country:US
Mailing Address - Phone:281-748-4100
Mailing Address - Fax:
Practice Address - Street 1:4646 WILD INDIGO ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7189
Practice Address - Country:US
Practice Address - Phone:281-748-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD477937207N00000X
AZR76836207R00000X
TXU3884207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine