Provider Demographics
NPI:1982717526
Name:NG, AMELIA WONG (MD)
Entity Type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:WONG
Last Name:NG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMELIA
Other - Middle Name:WONG
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1213 HERMANN DRIVE
Mailing Address - Street 2:STE 260
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7074
Mailing Address - Country:US
Mailing Address - Phone:713-527-9993
Mailing Address - Fax:713-527-8999
Practice Address - Street 1:1213 HERMANN DR STE 260
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7074
Practice Address - Country:US
Practice Address - Phone:713-527-9993
Practice Address - Fax:713-527-8999
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1409207RP1001X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175456601Medicaid
TX175456602Medicaid
TX610825Medicare ID - Type Unspecified
TX61290Medicare PIN
TXI09830Medicare UPIN
TX175456601Medicaid