Individual provider Active NPI

Brant G Wang, M.D., PH.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Houston, TX
National Provider Identifier
1124293873
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
V1644 Issued in TX
Practice address
1504 Taub Loop
Houston, TX 77030-1608
Phone
(713) 798-1750
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 0101248829 VA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X D0067139 MD
Cytopathology Physician 207ZC0500X V1644 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD037901 DC
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X V1644 TX Primary

Addresses

Primary practice location

1504 Taub Loop
Houston, TX 77030-1608

Mailing address

PO Box 37504
Baltimore, MD 21297-3504
Phone (703) 321-3700

Other practice location 1

110 Irving St NW
Washington Hospital Center
Washington, DC 20010-3017
Phone (202) 877-3627

Other practice location 2

2832 Juniper St
Fairfax, VA 22031-4402
Phone (703) 645-6190

Other names 1

  • Dr. Gang Wang Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20100602000112 DC Practitioner - Pathology 2062589278 Reassigns benefits to 2 organizations
I20140508001022 VA Practitioner - Pathology 2062589278 Reassigns benefits to 2 organizations
I20240731001521 TX Practitioner - Pathology 2062589278 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8527956176, 47 clinicians

Practice addresses (Care Compare)

21214 Northwest Fwy
Cypress, TX 77429-3373
Phone (713) 432-1500

6720 Bertner Ave
Houston, TX 77030-2604
Phone (713) 481-3500

Hospital & facility affiliations

  • Baylor St Lukes Medical Center Hospital, Houston, TX, CCN 450193

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V1644TXMDCytopathology Physician
0101248829VAMDCytopathology Physician
D0067139MDMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jul 1, 2024 Accepting new patients
Inova Health Care Services - Pathology Anatomic Pathology & Clinical Pathology CurrentSince Mar 15, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2024 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2015 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2015 Accepting new patients
Baylor College of Medicine Cytopathology CurrentSince Aug 15, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2024 Accepting new patients
Baylor College of Medicine Past Accepting new patients
Pathstar, P.C. Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

1115 Avenue G
Bay City, TX 77414
Phone (979) 245-6383

1504 Taub Loop
#285
Houston, TX 77030
Phone (713) 873-2626

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

1 Baylor Plz
#2
Houston, TX 77030

481 Ih 45 S
Ste 7
Huntsville, TX 77340
Phone (409) 291-9704

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

2555 Jimmy Johnson Blvd
Port Arthur, TX 77640
Phone (409) 724-7389

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

2832 Juniper St
Fairfax, VA 22031
Phone (703) 645-6134

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1124293873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37504",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973504",
            "telephone_number": "703-321-3700",
            "fax_number": "703-321-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 TAUB LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301608",
            "telephone_number": "713-798-1750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Irving St NW",
            "address_2": "Washington Hospital Center",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200103017",
            "country_code": "US",
            "telephone_number": "202-877-3627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2832 Juniper St",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314402",
            "country_code": "US",
            "telephone_number": "703-645-6190",
            "fax_number": "703-645-6136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "BRANT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "VA",
            "license": "0101248829",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MD",
            "license": "D0067139",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "TX",
            "license": "V1644",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "DC",
            "license": "MD037901",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "V1644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GANG",
            "last_name": "WANG",
            "prefix": "DR.",
            "credential": "M.D., PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.