Provider Demographics
NPI:1285993675
Name:WONG, PEI CHERN (RNFA)
Entity type:Individual
Prefix:
First Name:PEI
Middle Name:CHERN
Last Name:WONG
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 670039
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75367-0039
Mailing Address - Country:US
Mailing Address - Phone:214-378-9898
Mailing Address - Fax:214-387-9888
Practice Address - Street 1:10830 N CENTRAL EXPY
Practice Address - Street 2:SUITE 120
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-1050
Practice Address - Country:US
Practice Address - Phone:214-378-9898
Practice Address - Fax:214-378-9888
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX585147163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical