Provider Demographics
NPI:1467544791
Name:STELLA S. KWONG, M.D., P.A.
Entity type:Organization
Organization Name:STELLA S. KWONG, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES, SEC, TREAS.
Authorized Official - Prefix:DR
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KWONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-530-5550
Mailing Address - Street 1:2825 BELT LINE RD
Mailing Address - Street 2:SUITE # 103
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-7011
Mailing Address - Country:US
Mailing Address - Phone:972-530-5550
Mailing Address - Fax:972-530-3632
Practice Address - Street 1:2825 BELT LINE RD
Practice Address - Street 2:SUITE # 103
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-7011
Practice Address - Country:US
Practice Address - Phone:972-530-5550
Practice Address - Fax:972-530-3632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0748174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00SF84Medicare ID - Type Unspecified
TXB24181Medicare UPIN