Provider Demographics
NPI:1356468839
Name:WONG, HARRY Y (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:Y
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8300 WILCREST DR STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-4326
Mailing Address - Country:US
Mailing Address - Phone:134-612-9157
Mailing Address - Fax:832-460-7736
Practice Address - Street 1:8300 WILCREST DR STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-4326
Practice Address - Country:US
Practice Address - Phone:713-461-2915
Practice Address - Fax:832-460-7736
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK5748207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092291603Medicaid
TX1356468839OtherAMERIGROUP
TX1558380790OtherAMERIGROUP
TX183751001Medicaid