Provider Demographics
NPI:1841511359
Name:WANG, JIA (MD)
Entity type:Individual
Prefix:
First Name:JIA
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1200 BINZ ST
Mailing Address - Street 2:SUITE 520
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6900
Mailing Address - Country:US
Mailing Address - Phone:832-930-1275
Mailing Address - Fax:832-218-7365
Practice Address - Street 1:1200 BINZ ST
Practice Address - Street 2:SUITE 520
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6900
Practice Address - Country:US
Practice Address - Phone:832-930-1275
Practice Address - Fax:832-218-7365
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2015-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP100368412084P0800X
TXP92762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry