Provider Demographics
NPI:1134251457
Name:WONG-LIANG, EIRENE M (PHD)
Entity type:Individual
Prefix:
First Name:EIRENE
Middle Name:M
Last Name:WONG-LIANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BENDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3701
Mailing Address - Country:US
Mailing Address - Phone:713-981-8325
Mailing Address - Fax:
Practice Address - Street 1:10101 SOUTHWEST FWY STE 128
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1126
Practice Address - Country:US
Practice Address - Phone:713-981-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24919103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10020441OtherAMERIGROUP
TX099545802Medicaid
TX00N44CMedicare PIN