Wong, Shannon M

Wong, Shannon M is an individual health care provider with primary practice located at 11901 Jollyville Rd , Austin TX 78759-2303. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Wong, Shannon M can be contacted via phone (572) 250-2020.

Contact Information

Primary practice address
11901 Jollyville Rd Austin TX 78759-2303
Phone: (572) 250-2020
Fax: (572) 250-2612
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X J6050 Texas
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X J6050 Texas

Profile Details

NPI number 1497753040
LBN Legal business name Wong, Shannon M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Sep 8th, 2020 - about 6 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 1497753040 NPPES
Texas MEDICAID 038163401

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