Provider Demographics
NPI:1760421473
Name:WONG, EDWARD SANG (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:SANG
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4299 SAN FELIPE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-2916
Mailing Address - Country:US
Mailing Address - Phone:832-476-3900
Mailing Address - Fax:832-476-3990
Practice Address - Street 1:2220 EDWARD HOLLAND DRIVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2519
Practice Address - Country:US
Practice Address - Phone:804-678-7091
Practice Address - Fax:804-204-1724
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2009-11-17
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Provider Licenses
StateLicense IDTaxonomies
VA0101036283207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1760421473Medicaid
VA1760421473Medicaid