Fan Wang MD PHD OB GYN PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M2236 Issued in TX

Legal business name

FAN WANG MD PHD OB GYN PLLC

Practice address

6671 Southwest Fwy Ste 320
Houston, TX 77074-2220

Phone

(713) 884-8887

Fax

(713) 884-8480

NPI assigned

Jul 17, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fan Wang, MD, PHDNPI 1942263009

Title

Owner

Phone

(832) 782-3777

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fan Wang, M.D., PH.D.

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1942263009
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1003046541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WINDSOR PL",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770553900",
            "telephone_number": "713-884-8887",
            "fax_number": "713-884-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6671 SOUTHWEST FWY STE 320",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742220",
            "telephone_number": "713-884-8887",
            "fax_number": "713-884-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAN WANG MD PHD OB GYN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "FAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-782-3777",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "M2236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177382201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Tree Community Services LLC
• Family Walk-in Clinic Corp
• Familycare Pediatric P.a
• Familycare Supplies LLC
• Familymedix PLLC
• Aaron En-Kuang Fan, MD, PHD
• Christopher Fan, M.D.
• Jinping Fan, MD
• Joshua Zhigang Fan, MD
• Kimberly Fan, MD

• Obstetrics & Gynecology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.