Individual provider Active NPI

Min Tzu Wang

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1083907166
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q1764 Issued in TX
Practice address
11490 Westheimer Rd Ste 1000
Houston, TX 77077-6853
Phone
(626) 627-4627
NPI assigned
May 23, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Q1764 TX Primary

Addresses

Primary practice location

11490 Westheimer Rd Ste 1000
Houston, TX 77077-6853

Mailing address

18903 Villa Bergamo LN
Houston, TX 77094-1277

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
I20150402000425 TX Practitioner - Emergency Medicine 9537486469 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q1764TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Southwest, PA Single Specialty CurrentSince Apr 1, 2015 Accepting new patients
Round Table Specialist Group, PLLC Single Specialty Current Accepting new patients
Round Table Physicians Group PLLC Single Specialty CurrentSince Mar 1, 2020 Accepting new patients

Locations

5701 W Slaughter Ln
Bldg G
Austin, TX 78749
Phone (512) 651-5787

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

12141 Richmond Ave
Houston, TX 77082
Phone (281) 558-3444

11103 Westheimer Rd
Houston, TX 77042
Phone (832) 708-3651

11490 Westheimer Rd
Fl 10
Houston, TX 77077

1014 Wirt Rd
Ste 200
Houston, TX 77055
Phone (713) 527-5000

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

800 W Central Texas Expy
Killeen, TX 76541
Phone (254) 220-4117

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1083907166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18903 VILLA BERGAMO LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11490 WESTHEIMER RD STE 1000",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770776853",
            "telephone_number": "626-627-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "MIN",
        "middle_name": "TZU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-23",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q1764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.