Provider Demographics
NPI:1972102374
Name:WANG, KAIZHEN (NP)
Entity Type:Individual
Prefix:
First Name:KAIZHEN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 NORTH LOOP W STE 299
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1368
Mailing Address - Country:US
Mailing Address - Phone:713-955-7345
Mailing Address - Fax:832-648-7747
Practice Address - Street 1:1919 NORTH LOOP W STE 299
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1368
Practice Address - Country:US
Practice Address - Phone:713-955-7345
Practice Address - Fax:832-648-7747
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1006448363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty