Wong, Kevan L

Wong, Kevan L is an individual health care provider with primary practice located at 4144 N Central Expy Ste 360, Dallas TX 75204-2156. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Wong, Kevan L can be contacted via phone (214) 827-7460.

Contact Information

Primary practice address
4144 N Central Expy Ste 360 Dallas TX 75204-2156
Phone: (214) 827-7460
Fax: (214) 826-6858
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X L1243 Texas
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X L1243 Texas

Profile Details

NPI number 1336144500
LBN Legal business name Wong, Kevan L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Nov 3rd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336144500 NPPES
Texas Other 8EH854 BCBS
Texas Other P01446832 BCBS
Texas MEDICAID 040825401 BCBS
Texas MEDICAID 040825404 BCBS

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