Provider Demographics
NPI:1396725321
Name:WONG, ALVIN PUI SHUI (MD)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:PUI SHUI
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALVIN
Other - Middle Name:PUISHUI
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0865
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:6606 LBJ FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6533
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61492391207L00000X
TXK3537207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125512708Medicaid
TX125512709Medicaid
TX8EY202OtherBCBS
WA2267988Medicaid
TXP01499369OtherRR
TX125512710Medicaid
TX125512706Medicaid
TX125512707Medicaid
TX8B8924Medicare ID - Type UnspecifiedMCKINNEY
TX125512707Medicaid
TX8B8937Medicare ID - Type UnspecifiedDENTON
TX125512706Medicaid
TX125512708Medicaid