Provider Demographics
NPI:1811320237
Name:WANG, WENDY Y (NP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:Y
Last Name:WANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 ALLIANCE BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5363
Mailing Address - Country:US
Mailing Address - Phone:469-800-6000
Mailing Address - Fax:469-800-6057
Practice Address - Street 1:4708 ALLIANCE BLVD STE 550
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5363
Practice Address - Country:US
Practice Address - Phone:469-800-6000
Practice Address - Fax:469-800-6057
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23478363LG0600X
TXAP137350363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology