Individual provider Active NPI

Yi Wang, M.D.

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1073957189
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q1766 Issued in TX
Practice address
6677 Rookin St
Houston, TX 77074-5015
Phone
(713) 666-6700
Fax
(713) 666-0188
NPI assigned
Apr 19, 2013
Last updated
Mar 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X Q1766 TX Primary

Addresses

Primary practice location

6677 Rookin St
Houston, TX 77074-5015

Mailing address

PO Box 66308
Houston, TX 77266-6308
Phone (832) 548-5000

Other practice location 1

3430 Center St
Deer Park, TX 77536-5056
Phone (832) 548-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170802002635 TX Practitioner - Pediatric Medicine 8022389584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q1766TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Community Health Services, Inc CurrentSince Jun 23, 2017 Accepting new patients
Legacy Community Health Services, Inc Pediatrics CurrentSince Jun 23, 2017 Accepting new patients

Locations

3430 Center St
Deer Park, TX 77536
Phone (832) 266-7303

6441 High Star Dr
Houston, TX 77074
Phone (832) 548-5300

6500 Rookin St
Ste 200
Houston, TX 77074
Phone (713) 351-7350

6677 Rookin St
Houston, TX 77074
Phone (713) 666-6700

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1073957189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308",
            "telephone_number": "832-548-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 ROOKIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770745015",
            "telephone_number": "713-666-6700",
            "fax_number": "713-666-0188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3430 Center St",
            "address_purpose": "LOCATION",
            "city": "Deer Park",
            "state": "TX",
            "postal_code": "775365056",
            "country_code": "US",
            "telephone_number": "832-548-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "YI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q1766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.