Provider Demographics
NPI:1982843264
Name:WANG, KAI-MIN (DC)
Entity Type:Individual
Prefix:DR
First Name:KAI-MIN
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:CARL
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:6605 MCCART AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-5633
Mailing Address - Country:US
Mailing Address - Phone:817-583-8168
Mailing Address - Fax:817-292-2628
Practice Address - Street 1:6605 MCCART AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-5633
Practice Address - Country:US
Practice Address - Phone:817-583-8168
Practice Address - Fax:817-292-2628
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27564111N00000X
TX11854111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor