Kevan L Wong, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

L1243 Issued in TX

Practice address

4144 N Central Expy
Ste 360
Dallas, TX 75204-2156

Phone

(214) 827-7460

Fax

(214) 826-6858

NPI assigned

Jun 15, 2005

Last updated

Nov 3, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1336144500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4144 N CENTRAL EXPY",
            "address_2": "STE 360",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042156",
            "telephone_number": "214-827-7460",
            "fax_number": "214-826-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4144 N CENTRAL EXPY",
            "address_2": "STE 360",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042156",
            "telephone_number": "214-827-7460",
            "fax_number": "214-826-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KEVAN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "L1243",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "L1243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EH854",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P01446832",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040825401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040825404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Ya-Ai Wong
• Jeremy Mun-Hing Wong, MD
• Kamen Wong
• Kelly Wong
• Kenneth Paul Wong, DDS
• Lilly Wong, RN
• Lolo Wong, D.D.S.
• Marshall L Wong, M.D.
• Mary Yimling Wong, WHNP
• Melissa Wong

• Anesthesiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.