Provider Demographics
NPI:1710329966
Name:DANNY WONG M.D. PA
Entity Type:Organization
Organization Name:DANNY WONG M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-427-2747
Mailing Address - Street 1:4201 GARTH RD
Mailing Address - Street 2:STE 321
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3167
Mailing Address - Country:US
Mailing Address - Phone:281-427-2747
Mailing Address - Fax:281-428-8480
Practice Address - Street 1:4201 GARTH RD
Practice Address - Street 2:STE 321
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3167
Practice Address - Country:US
Practice Address - Phone:281-427-2747
Practice Address - Fax:281-428-8480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0957207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00H72ZMedicare PIN