Provider Demographics
NPI:1528229606
Name:WANG, LI-LUN (DR)
Entity Type:Individual
Prefix:
First Name:LI-LUN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 N FRY RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-5746
Mailing Address - Country:US
Mailing Address - Phone:281-589-7777
Mailing Address - Fax:281-656-2205
Practice Address - Street 1:5516 N FRY RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-5746
Practice Address - Country:US
Practice Address - Phone:281-589-7777
Practice Address - Fax:281-656-2205
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice